Amendment SA4-SSA2-SB45

2025 - 2026 LEGISLATURE

LRBb0629/1

ALL:all

SENATE AMENDMENT 4, TO SENATE SUBSTITUTE AMENDMENT 2, TO SENATE BILL 45

July 2, 2025 - Offered by Senators Hesselbein, Smith, Spreitzer, Drake, L. Johnson, Roys, Carpenter, Dassler-Alfheim, Habush Sinykin, Keyeski, Larson, Pfaff, Ratcliff and Wall.

SB45-SSA2-SA4,1,1 At the locations indicated, amend the substitute amendment as follows:

SB45-SSA2-SA4,1,2 1. At the appropriate places, insert all of the following:

SB45-SSA2-SA4,1,3 “Section 1. 20.435 (1) (ck) of the statutes is created to read:

SB45-SSA2-SA4,1,6 20.435 (1) (ck) Emergency medical services grants. The amounts in the schedule for grants to municipalities to improve or expand emergency medical services under s. 256.42.

SB45-SSA2-SA4,2 Section 2. 20.435 (1) (ef) of the statutes is amended to read:

SB45-SSA2-SA4,1,10 20.435 (1) (ef) Lead-poisoning or lead-exposure services. The As a continuing appropriation, the amounts in the schedule for the purposes of providing grants under s. 254.151.

SB45-SSA2-SA4,3 Section 3. 20.435 (1) (fi) of the statutes is repealed.

SB45-SSA2-SA4,4 Section 4. 20.435 (1) (fk) of the statutes is amended to read:

SB45-SSA2-SA4,2,5 20.435 (1) (fk) Grants to establish advanced practice clinician health care provider training programs. Biennially, the amounts in the schedule for grants to hospitals, health systems, clinics, and educational entities that form health care education and training consortia under s. 146.615.

SB45-SSA2-SA4,5 Section 5. 20.435 (2) (g) of the statutes is amended to read:

SB45-SSA2-SA4,2,10 20.435 (2) (g) Alternative services of institutes and centers. All moneys received as payments for services under ss. 46.043 and 51.06 (1r) and (5) for provision of alternative services by mental health institutes under s. 46.043 and by centers for the developmentally disabled under s. 51.06 (1r).

SB45-SSA2-SA4,6 Section 6. 20.435 (2) (gk) of the statutes is amended to read:

SB45-SSA2-SA4,4,2 20.435 (2) (gk) Institutional operations and charges. The amounts in the schedule for care, other than under s. 51.06 (1r), provided by the centers for the developmentally disabled, to reimburse the cost of providing the services and to remit any credit balances to county departments that occur on and after July 1, 1978, in accordance with s. 51.437 (4rm) (c); for care, other than under s. 46.043, provided by the mental health institutes, to reimburse the cost of providing the services and to remit any credit balances to county departments that occur on and after January 1, 1979, in accordance with s. 51.42 (3) (as) 2.; for care of juveniles placed at the Mendota juvenile treatment center for whom counties are financially responsible under s. 938.357 (3) (d), to reimburse the cost of providing that care; for maintenance of state-owned housing at centers for the developmentally disabled and mental health institutes; for repair or replacement of property damaged at the mental health institutes or at centers for the developmentally disabled; for reimbursing the total cost of using, producing, and providing services, products, and care; and to transfer to the appropriation account under sub. (5) (kp) for funding centers. All moneys received as payments from medical assistance on and after August 1, 1978; as payments from all other sources including other payments under s. 46.10 and payments under s. 51.437 (4rm) (c) received on and after July 1, 1978; as medical assistance payments, other payments under s. 46.10, and payments under s. 51.42 (3) (as) 2. received on and after January 1, 1979; as payments from counties for the care of juveniles placed at the Mendota juvenile treatment center; as payments for the rental of state-owned housing and other institutional facilities at centers for the developmentally disabled and mental health institutes; for the sale of electricity, steam, or chilled water; as payments in restitution of property damaged at the mental health institutes or at centers for the developmentally disabled; for the sale of surplus property, including vehicles, at the mental health institutes or at centers for the developmentally disabled; and for other services, products, and care shall be credited to this appropriation, except that any payment under s. 46.10 received for the care or treatment of patients admitted under s. 51.10, 51.15, or 51.20 for which the state is liable under s. 51.05 (3), of forensic patients committed under ch. 971 or 975, admitted under ch. 975, or transferred under s. 51.35 (3), or of patients transferred from a state prison under s. 51.37 (5), to the Mendota Mental Health Institute or the Winnebago Mental Health Institute shall be treated as general purpose revenue — earned, as defined under s. 20.001 (4); and except that moneys received under s. 51.06 (6) may be expended only as provided in s. 13.101 (17). All moneys transferred under 2025 Wisconsin Act .... (this act), section 9219 (2), shall be credited to this appropriation account.

SB45-SSA2-SA4,7 Section 7. 20.435 (2) (gL) of the statutes is repealed.

SB45-SSA2-SA4,8 Section 8. 20.435 (4) (bm) of the statutes is amended to read:

SB45-SSA2-SA4,4,22 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 ss. 46.73 and 46.74, 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).

SB45-SSA2-SA4,9 Section 9. 20.435 (4) (bq) of the statutes is repealed.

SB45-SSA2-SA4,10 Section 10. 20.435 (4) (bu) of the statutes is created to read:

SB45-SSA2-SA4,5,5 20.435 (4) (bu) Payment processing program for farmers. Biennially, the amounts in the schedule to provide electronic benefit transfer and credit and debit card processing equipment and services to farmers’ markets and farmers who sell directly to consumers under s. 49.79 (7s).

SB45-SSA2-SA4,11 Section 11. 20.435 (4) (jw) of the statutes is amended to read:

SB45-SSA2-SA4,5,15 20.435 (4) (jw) BadgerCare Plus and hospital assessment. All moneys received from payment of enrollment fees under the program under s. 49.45 (23), all moneys transferred under s. 50.38 (9), all moneys transferred under s. 256.23 (6), all moneys transferred from the appropriation account under par. (jz), and 10 percent of all moneys received from penalty assessments under s. 49.471 (9) (c), for administration of the program under s. 49.45 (23), to provide a portion of the state share of administrative costs for the BadgerCare Plus Medical Assistance program under s. 49.471, for administration of the hospital assessment under s. 50.38, and for administration of the ambulance service provider fee under s. 256.23.

SB45-SSA2-SA4,12 Section 12. 20.435 (4) (pa) of the statutes is amended to read:

SB45-SSA2-SA4,5,23 20.435 (4) (pa) Federal aid; Medical Assistance and food stamp contracts administration. All federal moneys received for the federal share of the cost of contracting for payment and services administration and reporting, other than moneys received under pars. (nn) and (np), to reimburse 3rd parties for their costs under s. 49.475, for administrative contract costs for the food stamp program under s. 49.79, for grants under ss. 46.73 and 46.74, and for services of resource centers under s. 46.283.

SB45-SSA2-SA4,13 Section 13. 20.435 (5) (bw) of the statutes is amended to read:

SB45-SSA2-SA4,6,5 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.

SB45-SSA2-SA4,14 Section 14. 20.435 (5) (bx) of the statutes is created to read:

SB45-SSA2-SA4,6,9 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.

SB45-SSA2-SA4,15 Section 15. 20.435 (5) (ch) of the statutes is created to read:

SB45-SSA2-SA4,6,12 20.435 (5) (ch) Suicide and crisis lifeline grants. The amounts in the schedule for grants under s. 46.533.

SB45-SSA2-SA4,16 Section 16. 20.435 (5) (ck) of the statutes is amended to read:

SB45-SSA2-SA4,6,16 20.435 (5) (ck) Crisis urgent care and observation facilities. Biennially As a continuing appropriation, the amounts in the schedule for grants to support crisis urgent care and observation facilities.

SB45-SSA2-SA4,17 Section 17. 20.435 (5) (ct) of the statutes is repealed.

SB45-SSA2-SA4,18 Section 18. 20.435 (5) (dg) of the statutes is created to read:

SB45-SSA2-SA4,6,21 20.435 (5) (dg) Grants for crisis stabilization facilities. The amounts in the schedule for grants to facilities that provide crisis stabilization services under s. 51.03 (7).

SB45-SSA2-SA4,19 Section 19. 20.940 of the statutes is repealed.

SB45-SSA2-SA4,20 Section 20. 36.47 of the statutes is created to read:

SB45-SSA2-SA4,6,24 36.47 Parkinson’s disease registry. (1) Definitions. In this section:

SB45-SSA2-SA4,7,2 (a) “Department” means the Population Health Institute, or its successor, at the University of Wisconsin-Madison School of Medicine and Public Health.

SB45-SSA2-SA4,7,3 (a) “Health care facility” has the meaning given in s. 155.01 (6).

SB45-SSA2-SA4,7,5 (b) “Health care provider” means a physician, surgeon, physician assistant, or nurse practitioner.

SB45-SSA2-SA4,7,11 (c) “Parkinsonism” means a condition that causes a combination of the movement abnormalities seen in Parkinson’s disease, including tremor at rest, slow movements, muscle rigidity, stooped posture, or unsteady or shuffling gait, which often overlap with and can evolve from what appears to be Parkinson’s disease. “Parkinsonism” includes multiple system atrophy, dementia with Lewy bodies, corticobasal degeneration, and progressive supranuclear palsy.

SB45-SSA2-SA4,7,16 (d) “Parkinson’s disease” means a chronic and progressive neurologic disorder resulting from deficiency of the neurotransmitter dopamine as the consequence of specific degenerative changes in the basal ganglia, which is characterized by tremor at rest, slow movements, muscle rigidity, stooped posture, and unsteady or shuffling gait.

SB45-SSA2-SA4,7,18 (2) Consultation by the department of health services. The department of health services may do all of the following:

SB45-SSA2-SA4,7,20 (a) Assist the department in the establishment and maintenance of a Parkinson’s disease registry, as provided under sub. (3).

SB45-SSA2-SA4,7,22 (b) Make recommendations to the department on the data to be collected in the Parkinson’s disease registry.

SB45-SSA2-SA4,7,23 (c) Advise the department on the Parkinson’s disease registry.

SB45-SSA2-SA4,8,2 (d) Make recommendations to the department on the best practices for the establishment of the Parkinson’s disease registry under sub. (3).

SB45-SSA2-SA4,8,8 (3) Parkinson’s disease registry. (a) By no later than the first day of the 19th month beginning after the effective date of this paragraph .... [LRB inserts date], the department shall, after consultation with the department of health services, establish and maintain a Parkinson’s disease registry for the collection, storage, and dissemination of information about the incidence and prevalence of Parkinson’s disease and parkinsonisms in this state.

SB45-SSA2-SA4,8,10 (b) The department shall collect and store in the Parkinson’s disease registry data reported under s. 255.18 (2) by health care providers and health care facilities.

SB45-SSA2-SA4,8,12 (c) The department shall prescribe the format for reporting information to the department under s. 255.18 (2).

SB45-SSA2-SA4,8,22 (d) The department shall create, and regularly review and revise, a list of information that health care providers and health care facilities must report, subject to s. 255.18 (2) (d), to the department under s. 255.18 (2). The list shall include the incident of a patient’s Parkinson’s disease or parkinsonism; necessary triggering diagnostic conditions, consistent with the latest version of the International Statistical Classification of Diseases and Related Health Problems; resulting case data on issues including diagnosis, treatment, and survival; and patient demographic information, including age, gender, and race. The Board of Regents of the University of Wisconsin System may promulgate rules to implement and administer this paragraph.

SB45-SSA2-SA4,9,2 (e) The University of Wisconsin-Madison may enter into agreements in order for the department to securely and confidentially receive information from data reporting entities and their associated electronic medical records vendors related to Parkinson’s disease testing, diagnosis, and treatment.

SB45-SSA2-SA4,9,7 (f) 1. The University of Wisconsin-Madison may enter into agreements in order for the department to disclose data collected in the Parkinson’s disease registry to another state’s Parkinson’s disease registry, a federal Parkinson’s disease control agency, a local health officer, or a researcher who proposes to conduct research on Parkinson’s disease.

SB45-SSA2-SA4,9,12 2. Before disclosing data containing confidential information to an entity under subd. 1., the University of Wisconsin-Madison shall require the entity to specify the purpose for the requested disclosure, agree in writing to maintain the confidentiality of the information and, if the entity is a researcher, provide all of the following to the University of Wisconsin-Madison:

SB45-SSA2-SA4,9,13 a. A written protocol to perform research.

SB45-SSA2-SA4,9,17 b. Documentation of approval of the research protocol by an institutional review board of a domestic institution that has a federalwide assurance approved by the office for human research protections of the federal department of health and human services.

SB45-SSA2-SA4,9,20 c. Documentation that demonstrates to the University of Wisconsin- Madison’s satisfaction that the researcher has established procedures and has the capability to maintain the confidentiality of the information.

SB45-SSA2-SA4,9,23 (4) Website. (a) By no later than the first day of the 19th month beginning after the effective date of this paragraph .... [LRB inserts date], the department shall establish and maintain a public website dedicated to the Parkinson’s disease registry under sub. (3). The department shall include on the website all of the following:

SB45-SSA2-SA4,10,4 1. Downloadable annual reports on the incidence and prevalence of Parkinson’s disease in this state.

SB45-SSA2-SA4,10,7 2. Relevant data, as determined by the department, about Parkinson’s disease and parkinsonisms for the 5-year period prior to the effective date of this subdivision .... [LRB inserts date].

SB45-SSA2-SA4,10,9 3. Other helpful resources about Parkinson’s disease, as determined by the department.

SB45-SSA2-SA4,10,11 (b) By no later than January 1 of each year, the department shall update the information specified in par. (a) 1. on the website maintained under par. (a).

SB45-SSA2-SA4,10,14 (c) The department shall publish on its website notice of the reporting requirement under s. 255.18 no fewer than 90 days before the reporting requirement takes effect.

SB45-SSA2-SA4,10,17 (5) Confidentiality. (a) Any information reported to the department under s. 255.18 (2) that could identify an individual who is the subject of the report or a health care provider submitting the report is confidential.

SB45-SSA2-SA4,10,20 (b) To ensure privacy, the department shall use a coding system for the data stored in the Parkinson’s disease registry that removes any identifying information about an individual who is the subject of a report under s. 255.18.

SB45-SSA2-SA4,10,24 (c) 1. If the University of Wisconsin-Madison or the department discloses confidential information as authorized under sub. (3) (f), the University of Wisconsin-Madison or department may include in the disclosure only the information necessary for the purpose specified under sub. (3) (f) 2.

SB45-SSA2-SA4,11,4 2. A person who obtains confidential information from the University of Wisconsin-Madison or the department under sub. (3) (f) may use the information only for the purpose specified under sub. (3) (f) 2. and may not redisclose the information.

SB45-SSA2-SA4,11,7 (d) The department shall maintain an accurate record of all persons given access to confidential information under this section. The record shall include all of the following:

SB45-SSA2-SA4,11,8 1. The name of the person authorizing access.

SB45-SSA2-SA4,11,9 2. The title, address, and organizational affiliation of any person given access.

SB45-SSA2-SA4,11,10 3. The dates of access.