SB462: Bill Text

SB462,,46 10. Security considerations for patients and staff at the facility.

SB462,,47 11. The estimated population to be served.

SB462,,48 12. The estimated number of diversions from the Winnebago Mental Health Institute had the facility been operating the past 5 years.

SB462,,49 13. Policies that ensure the facility has the capacity to assess physical health needs and deliver care for most minor physical health challenges, while also having an identified process in order to transfer an individual to a facility with more medically staffed services if needed.

SB462,,50 (e) No later than June 30 of each year, beginning by June 30, 2025, the department shall submit to the joint committee on finance a report regarding crisis urgent care and observation facilities under this section, including information relating to all of the following:

SB462,,51 1. Applications for certification received by the department.

SB462,,52 2. The number of admissions, including both voluntary and involuntary admissions.

SB462,,53 3. Data regarding how patients are arriving for admission, including through transport by law enforcement, family, emergency medical responders or emergency medical services practitioners, or county crisis personnel.

SB462,,54 4. Average wait times.

SB462,,55 5. The length of patient stays.

SB462,,56 6. The time of day patients are admitted.

SB462,,57 7. The source of payments for patient care, including private payment sources or payment under the Medical Assistance program under subch. IV of ch. 49.

SB462,,58 8. Data regarding the county of residence for each patient in counties for which the county’s data is equal to or greater than 20 patients.

SB462,,59 9. The estimated number of diversions from the Winnebago Mental Health Institute.

SB462,,60 10. A description of the number and type of employees providing staffing during the various times of day.

SB462,,61 11. A description of rules and procedures for determining where to take an individual in need of crisis services if a crisis urgent care and observation facility does not have capacity or otherwise does not accept an individual.

SB462,,62 (3) Admissions. (a) A crisis urgent care and observation facility certified under this section may accept individuals for any of the following services:

SB462,,63 1. Voluntary stabilization.

SB462,,64 2. Observation and treatment, including for assessments for mental health or substance use disorder.

SB462,,65 3. Screening for suicide and violence risk.

SB462,,66 4. Medication management and therapeutic counseling.

SB462,,67 (b) A crisis urgent care and observation facility certified under this section shall accept an adult individual for emergency detention under s. 51.15 and may accept a youth for emergency detention under s. 51.15. If the facility does not have capacity to accept an adult individual for purposes of emergency detention or if the facility does not accept a youth for purposes of emergency detention, that individual shall be transported to another appropriate facility in accordance with rules established by the department under sub. (4). A county crisis assessment under s. 51.15 (2) (c) is required prior to admission to a crisis urgent care and observation facility for purposes of emergency detention, but the medical clearance requirement under s. 51.15 (2) (b) does not apply to crisis urgent care and observation facility admissions for purposes of emergency detention.

SB462,,68 (c) The department shall encourage each crisis urgent care and observation facility certified under this section to operate with the intent to admit individuals for no longer than 5 days, except in exceptional circumstances.

SB462,,69 (4) Rules. The department shall promulgate rules to implement this section, including all of the following:

SB462,,70 (a) Establishment of the grant program described under sub. (2), including procedures for administration and establishment of criteria for awarding grants.

SB462,,71 (b) Establishment of requirements for crisis urgent care and observation facilities to match a portion of any grant awarded by the department under this section, as set forth under sub. (2) (c) 10., and for determining what types of contributions may count toward the matching requirement. The matching requirement established by the department under this paragraph may be fulfilled through in-kind contributions.

SB462,,72 (c) Requirements for admitting, holding, and discharging individuals for purposes of emergency detention.

SB462,,73 (d) Minimum security requirements for crisis urgent care and observation facilities certified under this section.

SB462,,74 (e) Establishment of a target range for the number of beds in a crisis urgent care and observation facility certified under this section.

SB462,,75 (f) Establishment of policies and criteria to ensure that law enforcement and other persons authorized to transport or cause transportation of an individual for purposes of emergency detention have clear standards and procedures regarding all of the following:

SB462,,76 1. The circumstances under which law enforcement and other persons may bring an individual to a crisis urgent care and observation facility certified under this section.

SB462,,77 2. The determination as to which facility law enforcement and other persons authorized to transport or cause transportation of an individual for purposes of emergency detention may take an individual.

SB462,,78 (g) Establishment of policies relating to interfacility transfers, including how such transfers should occur and who should be involved in such transfers. Barring exigent circumstances that necessitate law enforcement involvement, law enforcement may not transport an individual for purposes of an interfacility transfer from a crisis urgent care and observation facility.

SB462,,79 (h) Establishment of procedures to coordinate communication regarding bed availability before the arrival of a patient and establishment of a process for determining where to take an individual in need of crisis services if a crisis urgent care and observation facility does not have capacity or otherwise does not accept an individual.

SB462,,80 (i) Establishment of policies for coordination between crisis urgent care and observation facilities certified under this section and any facility established or operated with funding received under s. 165.12 from settlement proceeds from the opiate litigation, as defined in s. 165.12 (1), as well as policies to encourage awareness of and communication and coordination with other facilities that provide services similar to those provided by crisis urgent care and observation facilities.

SB462,,81 (j) Establishment of procedures to require a crisis urgent care and observation facility to coordinate continuity of care with, when appropriate, a hub-and-spoke health home pilot program for any patient treated at a crisis urgent care and observation facility for a period of 5 or fewer days. The department shall establish procedures for follow-up with other transition facilities in the event that a hub-and-spoke health home pilot program is appropriate but not available.

SB462,,82 (k) Establishment of policies and procedures for crisis urgent care and observation facilities that intend to accept both youths and adults, including requirements that youths be treated in a separate part of the facility from adults, policies to address youth-related treatment issues, including parental input, and staff training for youth-specific issues.

SB462,,83 (L) Establishment of appropriate staffing level requirements.

SB462,,84 (m) Establishment of requirements to define the population to be served at a given crisis urgent care and observation facility, including establishment of any minimum age requirements.

SB462,,85 (5) Coordination. In accordance with rules established by the department under sub. (4) (i), a crisis urgent care and observation facility certified under this section shall coordinate to the fullest extent possible with any facility established or operated with funding received under s. 165.12 from settlement proceeds from the opiate litigation, as defined in s. 165.12 (1), as well as with other facilities that provide services similar to those provided by crisis urgent care and observation facilities.

SB462,7 Section 7. 51.15 (2) (d) of the statutes is amended to read:

SB462,,87 51.15 (2) (d) Detention under this section may only be in a treatment facility approved by the department or the county department, if the facility agrees to detain the individual, or a state treatment facility. The department shall approve for purposes of this subsection any facility certified under s. 51.036.

SB462,8 Section 8. Nonstatutory provisions.

SB462,,89 (1) When considering the initial certifications of crisis urgent care and observation facilities under s. 51.036, the department of health services shall, to the fullest extent possible, prioritize certification of a crisis urgent care and observation facility to be located at least 100 miles from the Winnebago Mental Health Institute and in the region of the state defined as the western region according to the department’s division of the state into five regions by county as of January 5, 2023, for purposes of data analysis and communication.

SB462,,90 (end)