Amendment SA4-SSA2-SB45

SB45-SSA2-SA4,29 Section 29. 46.40 (8) of the statutes is amended to read:

SB45-SSA2-SA4,13,4 46.40 (8) Alzheimer’s family and caregiver support allocation. Subject to sub. (9), the department cannot distribute more than $3,058,900 $3,558,900 in each fiscal year for services to persons with Alzheimer’s disease and their caregivers under s. 46.87.

SB45-SSA2-SA4,30 Section 30. 46.48 (16) of the statutes is created to read:

SB45-SSA2-SA4,13,7 46.48 (16) Assistive technology. The department may distribute not more than $250,000 in each fiscal year for grants to provide assistive technology services.

SB45-SSA2-SA4,31 Section 31. 46.48 (21) of the statutes is created to read:

SB45-SSA2-SA4,13,13 46.48 (21) Trauma resilience grant. The department may distribute not more than $250,000 in fiscal year 2025-26 and not more than $250,000 in fiscal year 2026-27 as a grant to an organization in the city of Milwaukee to support the needs of individuals impacted by trauma and to develop the capacity of organizations to treat and prevent trauma.

SB45-SSA2-SA4,32 Section 32. 46.48 (21) of the statutes, as created by 2025 Wisconsin Act .... (this act), is repealed.

SB45-SSA2-SA4,33 Section 33. 46.48 (24) of the statutes is created to read:

SB45-SSA2-SA4,13,20 46.48 (24) Pediatric health psychology residency and fellowship training programs. The department may distribute not more than $600,000 in each fiscal year as grants to support pediatric health psychology residency and fellowship training programs.

SB45-SSA2-SA4,34 Section 34. 46.48 (27) of the statutes is created to read:

SB45-SSA2-SA4,14,4 46.48 (27) Community-based withdrawal management centers. From the appropriation under s. 20.435 (5) (bc), the department shall distribute not more than $500,000 in each fiscal year for grants to community-based withdrawal centers, including those certified as an adult residential integrated behavioral health stabilization service, residential intoxication monitoring service, or residential withdrawal management service, as those terms are defined under s. 49.45 (30p) (a) 1., 4., and 5.

SB45-SSA2-SA4,35 Section 35. 46.48 (33) of the statutes is created to read:

SB45-SSA2-SA4,14,8 46.48 (33) Diaper bank grants. The department may distribute not more than $500,000 in each fiscal year as grants to diaper banks to provide diapers to families in need.

SB45-SSA2-SA4,36 Section 36. 46.48 (34) of the statutes is created to read:

SB45-SSA2-SA4,14,12 46.48 (34) Maternal and child health. The department may distribute not more than $800,000 in each fiscal year as grants to local and community-based organizations whose mission is to improve maternal and child health in this state.

SB45-SSA2-SA4,37 Section 37. 46.48 (35) of the statutes is created to read:

SB45-SSA2-SA4,14,16 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 under s. 51.044.

SB45-SSA2-SA4,38 Section 38. 46.482 (1) (a) of the statutes is renumbered 46.482 (1) (bm).

SB45-SSA2-SA4,39 Section 39. 46.482 (1) (am) of the statutes is created to read:

SB45-SSA2-SA4,14,21 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.

SB45-SSA2-SA4,40 Section 40. 46.482 (1) (b) of the statutes is renumbered 46.482 (1) (c) and amended to read:

SB45-SSA2-SA4,15,2 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.

SB45-SSA2-SA4,41 Section 41. 46.482 (2) (a) of the statutes is amended to read:

SB45-SSA2-SA4,15,6 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.

SB45-SSA2-SA4,42 Section 42. 46.482 (2) (f) of the statutes is amended to read:

SB45-SSA2-SA4,15,10 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.

SB45-SSA2-SA4,43 Section 43. 46.533 of the statutes is created to read:

SB45-SSA2-SA4,15,15 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.

SB45-SSA2-SA4,15,19 (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.

SB45-SSA2-SA4,44 Section 44. 46.536 (1) of the statutes is renumbered 46.536 (1) (intro.) and amended to read:

SB45-SSA2-SA4,15,23 46.536 (1) (intro.) From the appropriation under s. 20.435 (5) (cf), the department shall award all of the following grants in the:

SB45-SSA2-SA4,16,9 (a) A total amount of $250,000 in each fiscal biennium to counties or regions comprised of multiple counties to establish or enhance crisis programs to serve individuals having crises in rural areas or counties, municipalities, or regions comprised of multiple counties or municipalities to establish and enhance law enforcement and behavioral health services emergency response collaboration programs. Grant recipients under this section paragraph shall match at least 25 percent of the grant amount awarded for the purpose that the grant is received. The department may not award any single grant in an amount greater than $100,000.

SB45-SSA2-SA4,45 Section 45. 46.536 (1) (b) of the statutes is created to read:

SB45-SSA2-SA4,16,15 46.536 (1) (b) A total amount of $2,000,000 in each fiscal biennium to counties, regions comprised of multiple counties, or municipalities to establish and enhance law enforcement and behavioral health services emergency response collaboration programs. Grant recipients under this paragraph shall match at least 25 percent of the grant amount awarded for the purpose that the grant is received.

SB45-SSA2-SA4,46 Section 46. 46.73 of the statutes is created to read:

SB45-SSA2-SA4,16,19 46.73 Community dental health coordinators. From the appropriations under s. 20.435 (4) (bm) and (pa), the department shall award grants to support community dental health coordinators in rural regions of the state.

SB45-SSA2-SA4,47 Section 47. 46.74 of the statutes is created to read:

SB45-SSA2-SA4,16,23 46.74 Grants for mobile dental clinics. The department shall award grants to community health centers, as defined in s. 250.15 (1) (a), to procure and operate mobile dental clinics.

SB45-SSA2-SA4,48 Section 48. 46.995 (4) of the statutes is created to read:

SB45-SSA2-SA4,17,4 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.

SB45-SSA2-SA4,49 Section 49. 48.375 (4) (a) 1. of the statutes is amended to read:

SB45-SSA2-SA4,17,15 48.375 (4) (a) 1. The person or the person’s agent has, either directly or through a referring physician or his or her agent, received and made part of the minor’s medical record, under the requirements of s. 253.10, the voluntary and informed written consent of the minor and the voluntary and informed written consent of one of her parents; or of the minor’s guardian or legal custodian, if one has been appointed; or of an adult family member of the minor; or of one of the minor’s foster parents, if the minor has been placed in a foster home and the minor’s parent has signed a waiver granting the department, a county department, or the foster parent the authority to consent to medical services or treatment on behalf of the minor.

SB45-SSA2-SA4,50 Section 50. 49.45 (2p) of the statutes is repealed.

SB45-SSA2-SA4,51 Section 51. 49.45 (2t) of the statutes is repealed.

SB45-SSA2-SA4,52 Section 52. 49.45 (3h) of the statutes is created to read:

SB45-SSA2-SA4,17,24 49.45 (3h) Payments to rural health clinics. (a) For services provided by a rural health clinic on or after the effective date of this paragraph .... [LRB inserts date], and before July 1, 2026, to a recipient of the Medical Assistance program under this subchapter, the department shall reimburse the rural health clinic under a payment methodology in effect on July 1, 2025, and in accordance with 42 USC 1396a (bb) (6).

SB45-SSA2-SA4,18,6 (b) For services provided by a rural health clinic on or after July 1, 2026, to a recipient of the Medical Assistance program under this subchapter, the department shall reimburse the rural health clinic using a payment methodology based on the Medicaid prospective payment system under 42 USC 1396a (bb) (1) to (3). The department shall consult with rural health clinics in developing the payment methodology under this paragraph.

SB45-SSA2-SA4,53 Section 53. 49.45 (6xm) of the statutes is created to read:

SB45-SSA2-SA4,18,11 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:

SB45-SSA2-SA4,18,12 1. The hospital is an acute care hospital located in this state.

SB45-SSA2-SA4,18,17 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.

SB45-SSA2-SA4,18,22 (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 $7,500,000 in each state fiscal year to hospitals that are free-standing pediatric teaching hospitals located in Wisconsin that have a percentage calculated under s. 49.45 (3m) (b) 1. a. greater than 45 percent.

SB45-SSA2-SA4,54 Section 54. 49.45 (19) (a) of the statutes is amended to read:

SB45-SSA2-SA4,19,6 49.45 (19) (a) As a condition of eligibility for medical assistance, a person shall, notwithstanding other provisions of the statutes except as provided in par. (cm), be deemed to have assigned to the state, by applying for or receiving medical assistance, any rights to medical support or other payment of medical expenses from any other person, including rights to unpaid amounts accrued at the time of application for medical assistance as well as any rights to support accruing during the time for which medical assistance is paid.

SB45-SSA2-SA4,55 Section 55. 49.45 (19) (c) of the statutes is repealed.

SB45-SSA2-SA4,56 Section 56. 49.45 (19) (cm) of the statutes is created to read:

SB45-SSA2-SA4,19,10 49.45 (19) (cm) Notwithstanding par. (a), birth expenses may not be recovered by the state under this subsection.

SB45-SSA2-SA4,57 Section 57. 49.45 (23) of the statutes is repealed.

SB45-SSA2-SA4,58 Section 58. 49.45 (23b) of the statutes is repealed.

SB45-SSA2-SA4,59 Section 59. 49.45 (24k) (c) of the statutes is repealed.

SB45-SSA2-SA4,60 Section 60. 49.45 (24L) of the statutes is created to read:

SB45-SSA2-SA4,19,20 49.45 (24L) Statewide dental contract. The department 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 to implement a statewide contract for dental benefits through a single vendor under the Medical Assistance program. If the federal government disapproves the amendment or waiver request, the department is not required to implement this subsection.

SB45-SSA2-SA4,61 Section 61. 49.45 (25c) of the statutes is created to read:

SB45-SSA2-SA4,20,3 49.45 (25c) Children’s behavioral health specialty managed care. The department may request a waiver from the federal department of health and human services to administer a children’s behavioral health specialty managed care program under the Medical Assistance program. If the waiver is granted, the department may administer the children’s behavioral health specialty managed care program under this subsection.

SB45-SSA2-SA4,62 Section 62. 49.45 (25d) of the statutes is created to read:

SB45-SSA2-SA4,20,9 49.45 (25d) Health-related social needs. The department shall request a waiver from the federal department of health and human services to provide reimbursement for services for health-related social needs under the Medical Assistance program. If the waiver is granted, the department shall provide reimbursement for services for health-related social needs under this subsection.

SB45-SSA2-SA4,63 Section 63. 49.45 (30) (a) of the statutes is repealed.

SB45-SSA2-SA4,64 Section 64. 49.45 (30) (b) of the statutes is renumbered 49.45 (30) and amended to read:

SB45-SSA2-SA4,20,18 49.45 (30) Services provided by community support programs. The department shall reimburse a provider of county that provides services under s. 49.46 (2) (b) 6. L. only for the amount of the allowable charges for those services under the Medical Assistance program that is provided by the federal government and for the amount of the allowable charges for those services under the Medical Assistance program that is not provided by the federal government.

SB45-SSA2-SA4,65 Section 65. 49.45 (30j) (title) of the statutes is amended to read:

SB45-SSA2-SA4,20,21 49.45 (30j) (title) Reimbursement for peer recovery coach and certified peer specialist services.

SB45-SSA2-SA4,66 Section 66. 49.45 (30j) (a) 1. and 2. of the statutes are renumbered 49.45 (30j) (a) 2m. and 3.

SB45-SSA2-SA4,67 Section 67. 49.45 (30j) (a) 1m. of the statutes is created to read:

SB45-SSA2-SA4,21,4 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.

SB45-SSA2-SA4,68 Section 68. 49.45 (30j) (bm) of the statutes is created to read:

SB45-SSA2-SA4,21,8 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:

SB45-SSA2-SA4,21,10 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.

SB45-SSA2-SA4,21,12 2. The certified peer specialist provides the service under the supervision of a competent mental health professional.

SB45-SSA2-SA4,21,15 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.

SB45-SSA2-SA4,21,18 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.

SB45-SSA2-SA4,69 Section 69. 49.45 (30j) (c) of the statutes is amended to read:

SB45-SSA2-SA4,21,22 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.

SB45-SSA2-SA4,70 Section 70. 49.45 (30p) of the statutes is created to read:

SB45-SSA2-SA4,22,2 49.45 (30p) Detoxification and stabilization services. (a) In this subsection:

SB45-SSA2-SA4,22,15 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.

SB45-SSA2-SA4,22,18 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.

SB45-SSA2-SA4,22,21 3. “Detoxification and stabilization services” means adult residential integrated behavioral health stabilization service, residential withdrawal management service, or residential intoxication monitoring service.

SB45-SSA2-SA4,23,7 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 health care. “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.

SB45-SSA2-SA4,23,20 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.