Chapter 146

146.615(1)(a) (a) “Advanced practice clinician” means a physician assistant or an advanced practice nurse, including a nurse practitioner, certified nurse-midwife, clinical nurse specialist, or certified registered nurse anesthetist.

146.615(1)(b) (b) “Clinic” has the meaning given in s. 146.903 (1) (b).

146.615(1)(c) (c) “Hospital” has the meaning given in s. 50.33 (2).

146.615(1)(d) (d) “Rural clinic” means a clinic that is located in a city, town, or village in this state that has a population of less than 20,000.

146.615(1)(e) (e) “Rural hospital” means a hospital that is located in a city, town, or village in this state that has a population of less than 20,000.

146.615(2) (2) Beginning in fiscal year 2018-19, from the appropriation under s. 20.435 (1) (fk), subject to sub. (3), the department shall distribute grants to hospitals and clinics that provide new training opportunities for advanced practice clinicians. The department shall distribute the grants under this section to hospitals and clinics that apply, in the form and manner determined by the department, to receive grants and that satisfy the criteria under sub. (3).

146.615(3) (3) 

146.615(3)(a) (a) The department may distribute up to $50,000 per fiscal year per hospital or clinic.

146.615(3)(b) (b) If the department distributes a grant to a hospital or clinic that has not previously received a grant under this section, the hospital or clinic receiving the grant may use the grant to create the education and infrastructure for training advanced practice clinicians or for activities authorized under par. (c). In distributing grants under this section, the department shall give preference to advanced practice clinician clinical training programs that include rural hospitals and rural clinics as clinical training locations.

146.615(3)(c) (c) If the department distributes a grant to a hospital or clinic that has previously received a grant under this section, the department shall require the hospital or clinic to use the grant to pay for the costs of operating a clinical training program for advanced practice clinicians, which may include any of the following:

146.615(3)(c)1. 1. Required books and materials.

146.615(3)(c)2. 2. Tuition and fees.

146.615(3)(c)3. 3. Stipends for reasonable living expenses.

146.615(3)(c)4. 4. Preceptor costs, including preceptor compensation attributable to training, certification requirements, travel, and advanced practice clinician training.

146.615(3)(d) (d) A recipient awarded a grant under this section shall match through its own funding sources the amount of the grant distributed by the department for the purposes of operating an advanced practice clinician rotation.

146.615(4) (4) A hospital or clinic sponsoring a training program for advanced practice clinicians supported by a grant under this section may determine what, if any, posteducation requirements must be fulfilled by participants in the training program for advanced practice clinicians.

146.615 History History: 2017 a. 59; 2021 a. 240 s. 30.

146.616 146.616 Allied health professional education and training grants.

146.616(1) (1) In this section:

146.616(1)(a) (a) “Allied health professional” means any individual who is a health care provider other than a physician, dentist, pharmacist, chiropractor, or podiatrist and who provides diagnostic, technical, therapeutic, or direct patient care and support services to the patient.

146.616(1)(b) (b) “Clinic” has the meaning given in s. 146.903 (1) (b).

146.616(1)(c) (c) “Hospital” has the meaning given in s. 50.33 (2).

146.616(1)(d) (d) “Rural clinic” means a clinic that is located in a city, town, or village in this state that has a population of less than 20,000.

146.616(1)(e) (e) “Rural hospital” means a hospital that is located in a city, town, or village in this state that has a population of less than 20,000.

146.616(2) (2) Beginning in fiscal year 2018-19, from the appropriation under s. 20.435 (1) (fi), subject to subs. (3) to (5), the department shall distribute grants to hospitals, health systems, and educational entities that form health care education and training consortia for allied health professionals. The department shall distribute the grants under this section to hospitals, health systems, and educational entities that apply, in the form and manner determined by the department, to receive a grant and that satisfy the requirements established by the department under sub. (4).

146.616(3) (3) 

146.616(3)(a) (a) The department may distribute up to $125,000 per fiscal year per consortium to be used for any of the following:

146.616(3)(a)1. 1. Curriculum and faculty development.

146.616(3)(a)2. 2. Tuition reimbursement.

146.616(3)(a)3. 3. Clinical site or simulation expenses.

146.616(3)(b) (b) A recipient awarded a grant under this section shall match through its own funding sources the amount of the grant distributed by the department for the purposes of operating an allied health professional training consortium.

146.616(4) (4) The department shall determine the requirements for the formation of health care education and training consortia for allied health professionals.

146.616(5) (5) In distributing grants under this section, the department shall give preference to rural hospitals, health systems with a rural hospital or rural clinic, and rural educational entities.

146.616 History History: 2017 a. 59; 2023 a. 19.

146.618 146.618 Treatment program grants. From s. 20.435 (5) (bg) or any available federal moneys, the department shall distribute a total of $750,000 in grants in each fiscal year to support treatment programs. Grant recipients shall use moneys awarded under this section for supervision, training, and resources, including salaries, benefits, and other related costs.

146.618 History History: 2019 a. 9; 2021 a. 58.

146.62 146.62 Rural hospital loan program.

146.62(1) (1) Definition. In this section:

146.62(1)(a) (a) “Hospital” has the meaning given under s. 50.33 (2).

146.62(1)(b) (b) “Rural” means outside a metropolitan statistical area, as specified under 42 CFR 412.62 (f) (ii) (A).

146.62(4) (4) Departmental duties. The department shall negotiate with each recipient of a loan made under s. 146.62 (2) and (3), 1989 stats., the schedule of repayments and collect the loan repayments as they are due. Loan repayments shall be deposited in the general fund. Except as provided in sub. (5), repayment for each loan shall begin no later than 12 months after the project funded under the loan begins operation.

146.62(5) (5) Loan forgiveness. If a rural hospital that receives a loan under s. 146.62 (2) and (3), 1989 stats., is unable to undertake the proposed project, the rural hospital may submit to the department a final report concerning the feasibility of loan repayment. The department shall review the report and may forgive all or part of the loan.

146.62 History History: 1989 a. 31; 1991 a. 39; 1993 a. 16; 2011 a. 258.

146.63 146.63 Grants to establish graduate medical training programs.

146.63(1) (1) Definition. In this section, “rural hospital” means a hospital, as defined under s. 50.33 (2), that is not located in a 1st class city.

146.63(2) (2) Departmental duties.

146.63(2)(a) (a) Subject to subs. (4) and (5), the department shall distribute grants from the appropriation under s. 20.435 (4) (bf) to assist rural hospitals and groups of rural hospitals in procuring infrastructure and increasing case volume to the extent necessary to develop accredited graduate medical training programs. The department shall distribute the grants under this paragraph to rural hospitals and groups of rural hospitals that apply to receive a grant under sub. (3) and that satisfy the criteria established by the department under par. (b) and the eligibility requirement under sub. (6).

146.63(2)(b) (b) The department shall establish criteria for approving and distributing grants under par. (a) and criteria for approving plans under sub. (3).

146.63(3) (3) Grant application. A rural hospital or group of rural hospitals may apply, in the form and manner determined by the department, to receive a grant under sub. (2) (a). The rural hospital or group of rural hospitals shall include in the application a plan to use the funds to procure infrastructure or increase case volume to the extent necessary to develop an accredited graduate medical training program at the rural hospital or group of rural hospitals and a plan to satisfy the matching requirement under sub. (4).

146.63(4) (4) Matching funds. The department may not distribute a grant under sub. (2) (a) unless the rural hospital or group of rural hospitals offers to provide matching funds in an amount determined by the department.

146.63(5) (5) Term of grants. The department may not distribute a grant under sub. (2) (a) for a term that is more than 5 years to a rural hospital or group of rural hospitals.

146.63(6) (6) Eligibility. A rural hospital or group of rural hospitals may receive a grant under sub. (3) if the plan to use the funds involves developing an accredited graduate medical training program in a specialty.

146.63 History History: 2013 a. 20; 2019 a. 9; 2023 a. 19, 185.

146.64 146.64 Grants to support graduate medical training programs.

146.64(1) (1) Definition. In this section, “hospital” has the meaning given under s. 50.33 (2).

146.64(2) (2) Departmental duties.

146.64(2)(a) (a) Subject to par. (c) and sub. (4), the department shall distribute grants to hospitals to fund the addition of positions to existing accredited graduate medical training programs. The department shall distribute the grants under this paragraph to all of the following:

146.64(2)(a)1. 1. Hospitals that apply to receive a grant under sub. (3) and that satisfy the criteria established by the department under par. (b) and the eligibility requirement under sub. (4).

146.64(2)(a)2. 2. Hospitals that received a grant under this paragraph in the immediately preceding fiscal year, unless the hospital no longer satisfies the criteria established by the department under par. (b), the hospital no longer has an accredited graduate medical training program, or the hospital has notified the department that the hospital no longer wishes to receive the grant. The department may not require a hospital under this subdivision to apply for a grant under this paragraph.

146.64(2)(b) (b) The department shall establish criteria for approving and distributing grants under par. (a).

146.64(2)(c) (c)

146.64(2)(c)1. 1. The department shall distribute funds for grants under par. (a) from the appropriation under s. 20.435 (4) (bf). The department may not distribute more than $75,000 from the appropriation under s. 20.435 (4) (bf) to fund a given position in a graduate medical training program in a given state fiscal year.

146.64(2)(c)2. 2. If the department receives matching federal medical assistance funds, the department shall distribute those funds for grants under par. (a) in addition to any funds distributed under subd. 1.

146.64(2)(d) (d) The department shall seek federal medical assistance funds to match the grants distributed under par. (a). If the department receives those funds, the department shall distribute them as provided in par. (c) 2.

146.64(3) (3) Grant application. Except as provided in sub. (2) (a) 2., a hospital may apply, in the form and manner determined by the department, to receive a grant under sub. (2) (a).

146.64(3m) (3m) Grant nonrenewal. A hospital that receives a grant under sub. (2) (a) shall notify the department, in the manner determined by the department, if the hospital no longer satisfies the criteria established by the department under sub. (2) (b), the hospital no longer has an accredited graduate medical training program, or the hospital no longer wishes to receive the grant.

146.64(4) (4) Eligibility. A hospital that has an accredited graduate medical training program in a specialty may apply to receive a grant under sub. (3).

146.64 History History: 2013 a. 20; 2019 a. 9; 2023 a. 185.

146.645 146.645 Grants to support the establishment or operation of graduate medical training consortia.

146.645(1) (1) Definitions. In this section:

146.645(1)(a) (a) “Graduate medical training consortium” means an independent, nonprofit organization formed by 2 or more entities to operate as a sponsoring institution for accredited graduate medical training programs at rural hospitals in this state.

146.645(1)(b) (b) “Rural hospital” has the meaning given in s. 146.63 (1).

146.645(1)(c) (c) “Sponsoring institution” means an entity that oversees, supports, and administers one or more accredited graduate medical training programs.

146.645(2) (2) Departmental duties.

146.645(2)(a) (a) The department shall distribute grants from the appropriation under s. 20.435 (4) (bf) to support the operational expenses of graduate medical training consortia. Subject to par. (c) and sub. (3), the department shall distribute grants to all of the following:

146.645(2)(a)1. 1. Graduate medical training consortia that apply to receive a grant under sub. (4) and that satisfy the criteria established by the department under par. (b) and the eligibility requirement under sub. (3).

146.645(2)(a)2. 2. A graduate medical training consortium that received a grant under this paragraph in the immediately preceding fiscal year, unless the graduate medical training consortium no longer satisfies the criteria established by the department under par. (b) or the eligibility requirement under sub. (3), the consortium is not accredited as a sponsoring institution by the Accreditation Council for Graduate Medical Education, or any successor organization, or another accrediting body as determined by the department, or the consortium has notified the department that the consortium no longer wishes to receive the grant.

146.645(2)(b) (b) The department shall establish criteria for approving and distributing grants under par. (a). The department may not require a consortium under par. (a) 2. to apply for a grant under that subdivision.

146.645(2)(c) (c)

146.645(2)(c)1. 1. The department shall distribute up to $375,000 in annual grants under par. (a) from the appropriation under s. 20.435 (4) (bf).

146.645(2)(c)2. 2. If the department receives matching federal Medical Assistance funds, the department shall distribute those funds for grants under par. (a) in addition to any funds distributed under subd. 1.

146.645(2)(d) (d) In awarding grants under par. (a), the department shall give preference to graduate medical training consortia that are the sponsoring institutions for graduate medical training programs in rural hospitals that have limited or no direct access to graduate medical training funding from the federal centers for medicare and medicaid services or have reached the maximum available amount of graduate medical training funding from the federal centers for medicare and medicaid services.

146.645(3) (3) Eligibility. A graduate medical training consortium may only receive a grant under this section if the graduate medical training consortium includes at least one partner rural hospital or health system.

146.645(4) (4) Grant application. Except as provided in sub. (2) (a) 2., a graduate medical training consortium may apply, in the manner determined by the department, to receive a grant under sub. (2) (a). A graduate medical training consortium shall identify all of the partner rural hospitals and health systems in the consortium in its grant application.

146.645(5) (5) Grant nonrenewal. A graduate medical training consortium that receives a grant under sub. (2) (a) shall notify the department, in the manner determined by the department, if the consortium no longer satisfies the criteria established by the department under sub. (2) (b) or the eligibility requirement under sub. (3), the consortium is not accredited as a sponsoring institution by the Accreditation Council for Graduate Medical Education, or any successor organization, or another accrediting body as determined by the department, or the consortium no longer wishes to receive the grant.

146.645(6) (6) Accreditation. A graduate medical training consortium shall, within 12 months of receiving a grant under sub. (2) (a), obtain and maintain accreditation as a sponsoring institution by the Accreditation Council for Graduate Medical Education, or any successor organization, or another accrediting body as determined by the department.

146.645(7) (7) Effect on graduate medical training expansion grants. The receipt of a grant under this section by a graduate medical training consortium does not affect the eligibility for a grant under s. 146.64 of any hospital that has an accredited graduate medical training program facilitated, organized, or implemented by the graduate medical training consortium.

146.645 History History: 2023 a. 185.

146.65 146.65 Rural health dental clinics.