Amendment SA4-SSA2-SB45

SB45-SSA2-SA4,76,4 256.12 (5) (a) From the appropriation account under s. 20.435 (1) (r), the department shall annually distribute funds to emergency medical responder departments or ambulance service providers that are public agencies, volunteer fire departments, or nonprofit corporations to purchase the training required for licensure and renewal of licensure as an emergency medical technician under s. 256.15 (6) or for certification and renewal of certification as an emergency medical responder under s. 256.15 (8), and to pay for administration of the examination required for licensure or renewal of licensure as an emergency medical technician services practitioner under s. 256.15 (6) (a) 3. and (b) 1. or certification or renewal of certification as an emergency medical responder under s. 256.15 (8).

SB45-SSA2-SA4,151 Section 151. 256.12 (5) (am) of the statutes is amended to read:

SB45-SSA2-SA4,76,19 256.12 (5) (am) If an emergency medical responder department or ambulance service provider does not use funds received under par. (a) within a calendar year, the emergency medical responder department or ambulance service provider may escrow those funds in the year in which the funds are distributed to the emergency medical responder department or ambulance service provider, except funds distributed for nondurable or disposable medical supplies or equipment or medications. In a subsequent year, an emergency medical responder department or ambulance service provider may use escrowed funds to purchase the training required for certification or renewal of certification as an emergency medical responder or licensure or renewal of licensure as an emergency medical services practitioner at any level or to pay for administration of the examination required for certification or renewal of certification as an emergency medical responder or for licensure or renewal of licensure as an emergency medical services practitioner at any level.

SB45-SSA2-SA4,152 Section 152. 256.23 (5) of the statutes is amended to read:

SB45-SSA2-SA4,77,2 256.23 (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.

SB45-SSA2-SA4,153 Section 153. 256.42 of the statutes is created to read:

SB45-SSA2-SA4,77,5 256.42 Emergency medical services grants. (1) In this section, “municipality” means a city, village, or town.

SB45-SSA2-SA4,77,9 (2) From the appropriation under s. 20.435 (1) (ck), the department shall award grants each fiscal year to municipalities to improve or expand emergency medical services. From the moneys appropriated each fiscal year, the department shall do all of the following:

SB45-SSA2-SA4,77,11 (a) Award 25 percent to municipalities to support the development of 24-7 paid service models in accordance with criteria developed by the department.

SB45-SSA2-SA4,77,14 (b) Award the remaining amount using a formula consisting of a base amount, determined by the department, for each municipality, plus a supplemental amount based on the population of the municipality.

SB45-SSA2-SA4,154 Section 154. 441.07 (1g) (f) of the statutes is repealed.

SB45-SSA2-SA4,155 Section 155. 448.02 (3) (a) of the statutes is amended to read:

SB45-SSA2-SA4,78,11 448.02 (3) (a) The board shall investigate allegations of unprofessional conduct and negligence in treatment by persons holding a license or certificate granted by the board. An allegation that a physician has violated s. 253.10 (3), 448.30 or 450.13 (2) or has failed to mail or present a medical certification required under s. 69.18 (2) within 21 days after the pronouncement of death of the person who is the subject of the required certificate or that a physician has failed at least 6 times within a 6-month period to mail or present a medical certificate required under s. 69.18 (2) within 6 days after the pronouncement of death of the person who is the subject of the required certificate is an allegation of unprofessional conduct. Information contained in reports filed with the board under s. 49.45 (2) (a) 12r., 50.36 (3) (b), 609.17 or 632.715, or under 42 CFR 1001.2005, shall be investigated by the board. Information contained in a report filed with the board under s. 655.045 (1), as created by 1985 Wisconsin Act 29, which is not a finding of negligence or in a report filed with the board under s. 50.36 (3) (c) may, within the discretion of the board, be used as the basis of an investigation of a person named in the report. The board may require a person holding a license or certificate to undergo and may consider the results of one or more physical, mental or professional competency examinations if the board believes that the results of any such examinations may be useful to the board in conducting its investigation.

SB45-SSA2-SA4,156 Section 156. 448.02 (3) (a) of the statutes, as affected by 2023 Wisconsin Act 172, section 4, and 2025 Wisconsin Act .... (this act), is repealed and recreated to read:

SB45-SSA2-SA4,79,9 448.02 (3) (a) The board shall investigate allegations of unprofessional conduct and negligence in treatment by persons holding a license or certificate granted by the board. An allegation that a physician has violated s. 448.30 or 450.13 (2) or has failed to present a medical certification required under s. 69.18 (2) within 21 days after the pronouncement of death of the person who is the subject of the required certificate or that a physician has failed at least 6 times within a 6- month period to present a medical certificate required under s. 69.18 (2) within 6 days after the pronouncement of death of the person who is the subject of the required certificate is an allegation of unprofessional conduct. Information contained in reports filed with the board under s. 49.45 (2) (a) 12r., 50.36 (3) (b), 609.17, or 632.715, or under 42 CFR 1001.2005, shall be investigated by the board. Information contained in a report filed with the board under s. 655.045 (1), as created by 1985 Wisconsin Act 29, which is not a finding of negligence or in a report filed with the board under s. 50.36 (3) (c) may, within the discretion of the board, be used as the basis of an investigation of a person named in the report. The board may require a person holding a license or certificate to undergo and may consider the results of one or more physical, mental or professional competency examinations if the board believes that the results of any such examinations may be useful to the board in conducting its investigation.

SB45-SSA2-SA4,157 Section 157. 457.26 (2) (gm) of the statutes is repealed.

SB45-SSA2-SA4,158 Section 158. 601.83 (1) (a) of the statutes is amended to read:

SB45-SSA2-SA4,79,24 601.83 (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.

SB45-SSA2-SA4,159 Section 159. 609.835 of the statutes is created to read:

SB45-SSA2-SA4,80,4 609.835 Coverage of prescription drugs and medical supplies to treat asthma. Limited service health organizations, preferred provider plans, and defined network plans are subject to s. 632.895 (16g).

SB45-SSA2-SA4,160 Section 160. 632.895 (16g) of the statutes is created to read:

SB45-SSA2-SA4,80,9 632.895 (16g) Coverage of prescription drugs and medical supplies to treat asthma. (a) In this subsection, “related medical supplies” includes asthma inhalers and other medical supply items necessary to effectively and appropriately administer a prescription drug prescribed to treat asthma.

SB45-SSA2-SA4,80,13 (b) Subject to par. (c), every disability insurance policy and every self-insured health plan of the state or of a county, city, town, village, or school district that provides coverage of prescription drugs shall cover prescription drugs and related medical supplies for the treatment of asthma.

SB45-SSA2-SA4,80,20 (c) A disability insurance policy or self-insured health plan of the state or of a county, city, town, village, or school district to which par. (b) applies shall limit the amount of any enrollee cost-sharing to no more than $25 per one-month supply for each prescription drug prescribed to treat asthma and to no more than $50 per month for all related medical supplies. The cost-sharing limitations under this paragraph may not increase with the number of conditions for which an enrollee is treated. Coverage under this subsection may not be subject to any deductible.

SB45-SSA2-SA4,81,5 (d) If, under federal law, application of par. (c) would result in ineligibility for a health savings account under section 223 of the Internal Revenue Code, par. (c) shall apply to a health-savings-account-qualified high deductible health plan with respect to the deductible of such a plan only after the enrollee has satisfied the minimum deductible under section 223 of the Internal Revenue Code, except with respect to items or services that are preventive care pursuant to section 223 (c) (2) (C) of the Internal Revenue Code, in which case par. (c) shall apply regardless of whether the minimum deductible under section 223 of the Internal Revenue Code has been satisfied.

SB45-SSA2-SA4,161 Section 161. 632.8985 of the statutes is repealed.

SB45-SSA2-SA4,162 Section 162. 939.75 (2) (b) 1. of the statutes is amended to read:

SB45-SSA2-SA4,81,10 939.75 (2) (b) 1. An act committed during an induced abortion. This subdivision does not limit the applicability of ss. 940.04, 940.13, 940.15 and 940.16 to an induced abortion.

SB45-SSA2-SA4,163 Section 163. 940.04 of the statutes is repealed.

SB45-SSA2-SA4,164 Section 164. 940.15 (5) of the statutes is repealed.

SB45-SSA2-SA4,165 Section 165. 968.26 (1b) (a) 2. a. of the statutes is amended to read:

SB45-SSA2-SA4,81,20 968.26 (1b) (a) 2. a. Section 940.04, 940.11, 940.19 (2), (4), (5), or (6), 940.195 (2), (4), (5), or (6), 940.198 (2) (b) or (c) or (3), 940.20, 940.201, 940.203, 940.204, 940.205, 940.207, 940.208, 940.22 (2), 940.225 (3), 940.29, 940.302 (2) (c), 940.32, 941.32, 941.38 (2), 942.09 (2), 943.10, 943.205, 943.32 (1), 946.43, 946.44, 946.47, 946.48, 948.02 (3), 948.03 (2) (b) or (c), (3), or (4), 948.04, 948.055, 948.095, 948.10 (1) (a), 948.11, 948.13 (2) (a), 948.14, 948.20, 948.23 (1), (2), or (3) (c) 2. or 3., or 948.30 (1).

SB45-SSA2-SA4,166 Section 166. DHS 107.07 (4) (k) 2. of the administrative code is repealed.

SB45-SSA2-SA4,167 Section 167. 2017 Wisconsin Act 370, section 44 (2) and (3) are repealed.

SB45-SSA2-SA4,168 Section 168. 2017 Wisconsin Act 370, section 44 (5) is repealed.

SB45-SSA2-SA4,9119 Section 9119. Nonstatutory provisions; Health Services.

SB45-SSA2-SA4,82,10 (1) Childless adults demonstration project. The department of health services shall submit any necessary request to the federal department of health and human services for a state plan amendment or waiver of federal Medicaid law or to modify or withdraw from any waiver of federal Medicaid law relating to the childless adults demonstration project under s. 49.45 (23), 2023 stats., to reflect the incorporation of recipients of Medical Assistance under the demonstration project into the BadgerCare Plus program under s. 49.471 and the termination of the demonstration project. The department of health services may submit a request to the federal department of health and human services to modify or withdraw from the waiver granted under s. 49.45 (23) (g), 2023 stats.

SB45-SSA2-SA4,82,20 (2) 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, 2027, or the date the permanent rules take effect, whichever is sooner.

SB45-SSA2-SA4,82,21 (3) Complex patient pilot program.

SB45-SSA2-SA4,82,22 (a) In this subsection:

SB45-SSA2-SA4,82,23 1. “Department” means the department of health services.

SB45-SSA2-SA4,83,2 2. “Partnership group” means one or more hospitals in partnership with one or more post-acute facilities.

SB45-SSA2-SA4,83,6 (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.

SB45-SSA2-SA4,83,11 (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.

SB45-SSA2-SA4,83,14 (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:

SB45-SSA2-SA4,83,18 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.

SB45-SSA2-SA4,83,20 2. Defined goals and measurable outcomes of the partnership group during the pilot program and after the pilot program.

SB45-SSA2-SA4,84,2 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.

SB45-SSA2-SA4,84,5 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:

SB45-SSA2-SA4,84,7 a. Estimated patient revenues from other sources, including the Medical Assistance program under subch. IV of ch. 49, and estimated total costs.

SB45-SSA2-SA4,84,8 b. A margin to account for reserved beds.

SB45-SSA2-SA4,84,10 5. The partnership group’s expertise to successfully implement the proposal, which may include a discussion of the following issues:

SB45-SSA2-SA4,84,12 a. Documented experience of the partners working together to serve complex patients.

SB45-SSA2-SA4,84,15 b. The implementation timeline and the plan for post-acute facilities to accept admissions and transfer patients within 72 hours of a request submitted by a hospital.

SB45-SSA2-SA4,84,19 c. The plan for an interdisciplinary team that will staff the unit in the post- acute facility, including the availability of staff with appropriate expertise that includes physicians, nurses, advance practice health professionals, pharmacists, physical therapists, occupational therapists, and social workers.

SB45-SSA2-SA4,84,20 d. Ability to electronically exchange health information.

SB45-SSA2-SA4,84,22 e. Resources to conduct patient intake and discharge planning from the post- acute facility, including case managers and social workers.

SB45-SSA2-SA4,85,2 f. Ability to conduct monthly case management reviews with the interdisciplinary team for every complex care patient that cover care plan progress and any readmissions to an acute care hospital.

SB45-SSA2-SA4,85,3 g. Ability to conduct monthly quality assurance reviews.

SB45-SSA2-SA4,85,4 h. Ability of the treatment model to be replicated by other healthcare systems.

SB45-SSA2-SA4,85,6 i. Plans to document decreases in lengths of stay for complex patients in hospitals and avoided hospital days.

SB45-SSA2-SA4,85,11 j. Documentation of stable finances among partnership group members to support the proposal, including matching funds that could be dedicated to the pilot program under this subsection. No applicant may be required to provide matching funds or a contribution, but the department may take into consideration the availability of matching funds or a contribution in evaluating an application.

SB45-SSA2-SA4,85,13 k. Description of anticipated impediments to successful implementation and how the partnership group intends to overcome the anticipated impediments.

SB45-SSA2-SA4,85,15 (e) In implementing this subsection, the department shall do all of the following:

SB45-SSA2-SA4,85,19 1. Develop a methodology to evaluate the complex patient pilot program and contract with an independent organization to complete the evaluation. The department may pay the fee of the organization selected from the appropriation under s. 20.435 (7) (d).

SB45-SSA2-SA4,85,21 2. Give additional weight to partnership groups that would ensure geographic diversity.

SB45-SSA2-SA4,86,2 (f) Upon completion of the evaluation required under par. (e) 1., the independent organization contracted by the department to complete the evaluation shall provide the evaluation to the department.

SB45-SSA2-SA4,86,9 (4) Newborn screening program; conditions approved as of January 1, 2025. For any disorder included in the federal recommended uniform screening panel approved by the federal department of health and human services as of January 1, 2025, that is not included in the list of disorders under s. DHS 115.04, Wis. Adm. Code, on the effective date of this subsection, the department of health services shall do all of the following within 18 months of the effective date of this subsection:

SB45-SSA2-SA4,86,11 (a) Evaluate whether the disorder should be included in the testing required under s. 253.13 (1).

SB45-SSA2-SA4,86,14 (b) If, in its evaluation, the department of health services determines that the disorder should be included in the testing required under s. 253.13 (1), commence rule making to add the disorder to the list under s. DHS 115.04, Wis. Adm. Code.

SB45-SSA2-SA4,86,20 (5) Newborn screening program; pending rule promulgation. Subsection (4) does not apply to any disorder included in the federal recommended uniform screening panel that will be added to the list of disorders under s. DHS 115.04, Wis. Adm. Code, pending promulgation of a rule for which the department of health services has commenced the rule-making procedure as of the effective date of this subsection.

SB45-SSA2-SA4,86,24 (6) Newborn screening program; testing start date. The department of health services shall ensure that testing for any disorder added by rule to the list under s. DHS 115.04, Wis. Adm. Code, in accordance with sub. (4) begins within 6 months after the date of publication, as defined in s. 227.22 (1), of the rule.

SB45-SSA2-SA4,87,13 (7) 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, 2027, or the date on which permanent rules take effect, whichever is sooner.

SB45-SSA2-SA4,87,21 (8) 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 2026-27, the department shall award $4,067,200 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.

SB45-SSA2-SA4,88,3 (9) Health care provider innovation grants. From the appropriation under s. 20.435 (4) (bm), the department of health services shall award $7,500,000 in fiscal year 2025-26 as grants to health care providers and long-term care providers to implement best practices and innovative solutions to increase worker recruitment and retention.

SB45-SSA2-SA4,88,8 (10) Falls prevention funding. From the appropriation under s. 20.435 (1) (b), the department of health services shall award a grant of $450,000 in each of fiscal years 2025-26 and 2026-27 to an organization committed to reducing falls among older adults in this state for the purpose of statewide falls prevention awareness and initiatives.

SB45-SSA2-SA4,88,11 (11) Reference changes. Wherever a reference to s. 253.10 (2) (a) appears in the statutes, the legislative reference bureau shall substitute a reference to s. 69.01 (13m), as it defines the term “induced abortion.”

SB45-SSA2-SA4,88,13 (12) Positions. The authorized positions for the department of health services are increased as provided in 2025 Senate Bill 45.

SB45-SSA2-SA4,88,16 (13) Funding At the appropriate place, replace the schedule for s. 20.435 with the schedule for 2025 Senate Bill 45 covering the department of health services.

SB45-SSA2-SA4,9123 Section 9123. Nonstatutory provisions; Insurance.

SB45-SSA2-SA4,88,19 (1) Positions. The authorized positions for office of the commissioner of insurance are increased as provided in 2025 Senate Bill 45.

SB45-SSA2-SA4,88,22 (2) Funding. At the appropriate place, replace the schedule for s. 20.145 with the schedule for 2025 Senate Bill 45 covering the office of the commissioner of insurance.

SB45-SSA2-SA4,9147 Section 9147. Nonstatutory provisions; University of Wisconsin System.

SB45-SSA2-SA4,89,5 (1) Funding allocation for a statewide Parkinson’s disease registry. From the appropriation under s. 20.285 (1) (a), the Board of Regents of the University of Wisconsin System shall allocate in fiscal year 2025-26, at least $3,900,000, and in fiscal year 2026-27, at least $2,400,000, to establish the statewide Parkinson’s disease registry under s. 36.47.

SB45-SSA2-SA4,9219 Section 9219. Fiscal changes; Health Services.

SB45-SSA2-SA4,89,9 (1) Extended intensive treatment surcharge balance transfer. The unencumbered balance in the appropriation account under s. 20.435 (2) (gL), 2023 stats., is transferred to the appropriation account under s. 20.435 (2) (g).

SB45-SSA2-SA4,89,13 (2) Winnebago Mental Health Institute. There is transferred from the general fund to the appropriation account under s. 20.435 (2) (gk) $18,599,500 in fiscal year 2025-26 and $15,251,000 in fiscal year 2026-27 to support the operations of Winnebago Mental Health Institute.

SB45-SSA2-SA4,9319 Section 9319. Initial applicability; Health Services.

SB45-SSA2-SA4,89,17 (1) Support and improvement of emergency medical services. The treatment of s. 256.12 (4) (a) and (c) of this act first applies to funds distributed under s. 256.12 (4) (a) on the effective date of this subsection.