AB467,,6649.45 (41) (a) (intro.) In this subsection, “crisis intervention services” means crisis intervention services for the treatment of mental illness, intellectual disability, substance abuse, and dementia that are provided by a any of the following:

AB467,,772. A crisis intervention program operated by, or under contract with, a county, if the county is certified as a medical assistance provider.

AB467,,9949.45 (41) (a) 1. A crisis urgent care and observation facility certified under s. 51.036.

AB467,,111149.45 (41) (b) If a county elects to become certified as a provider of crisis intervention services under par. (a) 2., the county may provide crisis intervention services under this subsection in the county to medical assistance recipients through the medical assistance program. A county that elects to provide the services shall pay the amount of the allowable charges for the services under the medical assistance program that is not provided by the federal government. The department shall reimburse the county under this subsection only for the amount of the allowable charges for those services under the medical assistance program that is provided by the federal government.

AB467,,131349.45 (41) (c) (intro.) Notwithstanding par. (b), if a county elects, pursuant to par. (a) 2., to deliver crisis intervention services under the Medical Assistance program on a regional basis according to criteria established by the department, all of the following apply:

AB467,,151549.45 (41) (d) The department shall, in accordance with all procedures set forth under s. 20.940, request a waiver under 42 USC 1315 or submit a Medical Assistance state plan amendment to the federal department of health and human services to obtain any necessary federal approval required to provide reimbursement to crisis urgent care and observation facilities certified under s. 51.036 for crisis intervention services under this subsection. If the department determines submission of a state plan amendment is appropriate, the department shall, notwithstanding whether the expected fiscal effect of the amendment is $7,500,000 or more, submit the amendment to the joint committee on finance for review in accordance with the procedures under s. 49.45 (2t). If federal approval is granted or no federal approval is required, the department shall provide reimbursement under s. 49.46 (2) (b) 15. If federal approval is necessary but is not granted, the department may not provide reimbursement for crisis intervention services provided by crisis urgent care and observation facilities.

AB467,,171751.036 Crisis urgent care and observation facilities. (1) Definitions. In this section:

AB467,,1818(a) “Crisis” means a situation caused by an individual’s apparent mental or substance use disorder that results in a high level of stress or anxiety for the individual, persons providing care for the individual, or the public and that is not resolved by the available coping methods of the individual or by the efforts of those providing ordinary care or support for the individual.

AB467,,1919(b) “Crisis urgent care and observation facility” means a treatment facility that admits an individual to prevent, de-escalate, or treat the individual’s mental health or substance use disorder and includes the necessary structure and staff to support the individual’s needs relating to the mental health or substance use disorder.

AB467,,2020(2) Certification required; exemption; grants. (a) The department shall establish a certification process for crisis urgent care and observation facilities and a grant program to award grants to develop and support crisis urgent care and observation facilities. No person may operate a crisis urgent care and observation facility without a certification under this section. The department may limit the number of certifications it grants to operate crisis urgent care and observation facilities. The department shall, using the department’s division of the state into regions by county, include statewide geographic consideration in its evaluation of applications for certification under this section to ensure geographic diversity among the regions in the location of crisis urgent care and observation facilities certified under this section.

AB467,,2121(b) 1. A crisis urgent care and observation facility certified under this section is not subject to facility regulation under ch. 50, unless otherwise required due to the facility’s licensure or certification for other services or purposes. A crisis urgent care and observation facility is not a hospital subject to approval under ss. 50.32 to 50.39 and nothing in this subsection limits services a hospital may provide under ch. 50.

AB467,,22222. Notwithstanding par. (d), the department shall promote certification and encourage any facility that is licensed as a hospital under ch. 50 and provides services consistent with those described in par. (c) 1. to 9. to apply for certification under this section. The requirements under this section may not be construed to prohibit, limit, or otherwise interfere with services provided by a county or a hospital or other facility that are provided consistent with the facility’s existing licensure or certification, whether the facility is publicly or privately funded.

AB467,,23233. Notwithstanding s. 150.93, any hospital that expands psychiatric bed capacity to accommodate admissions under this section may increase its approved bed capacity by the number of psychiatric beds added under this subdivision.

AB467,,24244. The department shall take into account the geography of hospital facilities granted certification under subd. 2. when considering certification applications for other crisis urgent care and observations facilities.

AB467,,2525(c) Subject to par. (d), the department may grant a certification to a crisis urgent care and observation facility that specifies in an application the level of care the facility can provide to patients and demonstrates in the application its ability to do all of the following:

AB467,,26261. Accept referrals for crisis services for adults and, if applicable, for youth, including involuntary patients under emergency detention, walk-ins, and individuals brought by law enforcement, emergency medical responders or emergency medical services practitioners, or county crisis personnel.

AB467,,27272. Abstain from having a requirement for medical clearance before admission assessment.

AB467,,28283. Provide assessments for physical health, substance use disorder, and mental health.

AB467,,29294. Provide screening for suicide and violence risk.

AB467,,30305. Provide medication management and therapeutic counseling.

AB467,,31316. Provide coordination of services for basic needs.

AB467,,32327. Provide for the safety and security of both the staff and the patients.

AB467,,33338. Have adequate staffing 24 hours a day, 7 days a week, including through use of telehealth, as described under s. 49.45 (61), with a multidisciplinary team that includes, as needed, psychiatrists or psychiatric nurse practitioners, nurses, licensed clinicians capable of completing assessments, peers with lived experience, and other appropriate staff.