2001 - 2002 LEGISLATURE
May 1, 2001 - Introduced by
Joint Legislative Council. Referred to Committee
1An Act to renumber and amend
20.235 (1) (d) and 20.435 2
(4) (b); and to create
20.435 (5) (h), 49.45 (2) (a) 25., 49.46 (2) (b) 1m., 250.13, 3
250.15 (1) (b) and 250.15 (2) (d) of the statutes; relating to: the state contract
4for dental education; authorizing licensed dental health professional positions
5in the department of health and family services; funding for dental services at
6community health centers; grants for community water fluoridation;
7increasing the medical assistance reimbursement rates for dental services;
8making topical fluoride varnish a covered service under the early and periodic
9screening, diagnosis, and treatment program; creating a fluoride varnish
10education program; reimbursement for dental hygienist services under medical
11assistance; medical assistance reimbursement for dental cleanings; requiring
12the exercise of rule-making authority; and making appropriations.
Analysis by the Legislative Reference Bureau
This bill is explained in the Notes provided by the joint legislative council in
For further information see the state fiscal estimate, which will be printed as
an appendix to this bill.
The people of the state of Wisconsin, represented in senate and assembly, do
enact as follows:
Prefatory note: This bill was prepared for the joint legislative council's special
committee on dental care access. The bill contains the following provisions:
Tuition Assistance: Marquette University School of Dentistry
Under current law, $1,167,000 is appropriated in each fiscal year to provide tuition
assistance of $11,670 per year for up to 100 Wisconsin residents attending Marquette
University School of Dentistry.
The bill increases the per student tuition assistance to $15,000 per year and
increases the maximum number of Wisconsin residents who qualify to 160. The amount
appropriated for this purpose is increased from the current $1,167,000 to $1,725,000 (115
x $15,000) in fiscal year 2001-02 to reflect an additional 15 Wisconsin residents in the
fall 2001 incoming class and to $1,950,000 (130 x $15,000) in fiscal year 2002-03 to reflect
those 15 students and an additional 15 Wisconsin residents in the fall 2002 incoming
class. When fully implemented in the fall of 2004, the amount of the appropriation would
be $2,400,000 (160 x $15,000).
Licensed Dental Health Professionals in the Department of Health and Family
This bill increases the current appropriation for DHFS under s. 20.435 (4) (bm),
stats., for medical assistance (MA) administration by $132,000 in each year of the
2001-03 biennium to increase the authorized general purpose revenue (GPR) positions
for DHFS by five GPR positions beginning on July 1, 2001. This funding would provide
one licensed dental health professional in each of the five DHFS administrative regions
for the division of public health, as prescribed by DHFS. These five licensed dental health
professionals would be responsible for performing dental health outreach services and for
providing dental care, primarily to persons eligible for MA.
Grants for Community Dental Services
The bill increases DHFS' current appropriation for community health services
under s. 20.435 (5) (fh), stats., by $1,600,000 in each year of the 2001-03 biennium. The
department must distribute these funds to qualified applicants for the provision or
expansion of dental care services. Under the bill, a "qualified applicant" is an entity that
provides, or seeks to provide or expand, dental services to low-income individuals and
that is not a federally qualified health center. A qualified applicant that receives a grant
must ensure that the following criteria are met:
1. The applicant must make every attempt to collect appropriate reimbursement
for its costs in providing dental services to persons who are entitled to BadgerCare, MA,
or assistance for medical expenses under any other public assistance or private insurance
2. The applicant must prepare and utilize a fee schedule for its services consistent
with locally prevailing charges for these services that is designed to cover its reasonable
costs. The applicant must also have a sliding fee scale for its patients.
3. The applicant must establish a governing board which, except in the case of an
applicant that is an Indian tribe or band, is composed of individuals who are
representative of persons served by the entity and a majority of whom are served by the
entity. The bill sets forth the responsibilities of the governing board.
4. The applicant must use any funds provided under the grant program to
supplement, and not supplant, other funds that are or may be available to the entity.
5. The applicant must implement a patient screening process to determine patient
eligibility for MA, BadgerCare, and the sliding fee scale.
6. The applicant must ensure that the following services are also provided:
a. Oral health education.
b. Dental screening, risk assessment, and preventive dental treatment to pregnant
women, infants, preschoolers, persons with diabetes, heart disease, and lung disease, and
persons using psychotropic medication.
Under this program, preference for funding is given to applicants that are located
in a dental health professional shortage area.
Grants for Community Water Fluoridation
The bill provides $25,000 GPR in each year of the 2001-03 biennium for a
community water fluoridation grant program. Under the program, DHFS must award
grants each year to applying communities in Wisconsin for any of the following purposes:
1. Purchase of water fluoridation equipment.
2. Construction of additional building space to house water fluoridation
3. Payment of salaries of employees who operate water fluoridation equipment.
Coverage of Topical Fluoride Varnish Under Early and Periodic Screening,
Diagnosis and Treatment (EPSDT) Program
This bill provides $162,930 GPR in fiscal year 2001-02 and $325,859 GPR in fiscal
year 2002-03 to provide coverage under the MA program for topical fluoride varnish
through the EPSDT program. The bill requires DHFS to promulgate rules regarding
coverage of topical fluoride varnish, which specify the following:
a. Coverage is provided through the EPSDT program for children ages 0 to 60
months of age.
b. The fluoride varnish may be applied by any EPSDT health care provider acting
within his or her scope of practice and licensure.
c. Payment shall be made for up to three applications per child per year of fluoride
d. Application of fluoride varnish may be, but is not required to be, provided in
conjunction with an EPSDT examination which includes a limited oral screening.
e. Health care professionals providing services under this program shall refer or
facilitate referral of children receiving topical fluoride varnish applications to
comprehensive dental care rendered by a dental professional.
The bill also requires DHFS to disseminate information to health care
professionals providing services under the EPSDT program and to parents or guardians
of children eligible for EPSDT services on the availability of, and coverage for, fluoride
varnish under EPSDT and the efficacy of fluoride varnish treatments in preventing early
MA Reimbursement Rate Increase for Dental Services
This bill provides $8,614,045 GPR for fiscal year 2001-02 and $11,628,960 GPR for
fiscal year 2002-03 to increase the MA reimbursement rates for dental services. Under
the bill, the reimbursement rates are increased to the 75th percentile of the fees from the
American Dental Association (ADA) fee survey for the east north central region, which
includes Wisconsin. The bill specifies that for each fiscal year, reimbursement rates shall
be established based on the most recently published ADA fee survey for that year.
MA Reimbursement for Dental Hygienist Services
Under current law, MA reimburses for dental services, limited to basic services
within each of the following categories: diagnostic services, preventive services,
restorative services, endodontic services, periodontic services, oral and maxillofacial
surgery services, emergency treatment of dental pain, removable prosthodontic services,
and fixed prosthodontic services.
The bill provides that MA will reimburse for basic services within the above
categories provided by dental hygienists for services that are within the scope of practice
of a dental hygienist.
MA Reimbursement for Two Dental Cleanings Per Year for Adults
Under current administrative rules of DHFS, MA provides reimbursement for one
dental cleaning per year for adults. The bill appropriates funds to pay for two such
cleanings per year.
AB366, s. 1
20.005 (3) (schedule) of the statutes at the appropriate place, insert 2
the following amounts for the purposes indicated:
- See PDF for table
AB366, s. 2
20.235 (1) (d) of the statutes is amended to read:
(d) Dental education contract.
The amounts in the schedule for 5
support of those Wisconsin residents enrolled as full-time students in the pursuit of 6
a doctor of dental surgery (D.D.S.) degree. An amount of $11,330 in the 1993-94 fiscal
7year and $11,670 in the 1994-95 $15,000 in each
fiscal year and annually thereafter 8
shall be disbursed under s. 39.46 for each Wisconsin resident enrolled as a full-time
student. The maximum number of Wisconsin residents to be funded under this 2
appropriation is 100 160
in the 1993-94 each
fiscal year and thereafter
Note: Increases the per-student tuition assistance for Wisconsin residents
attending the Marquette University School of Dentistry from $11,670 per year to $15,000
per year. Also increases the maximum number of Wisconsin residents who qualify for this
assistance from 100 to 160.
AB366, s. 3
20.435 (4) (b) of the statutes is amended to read:
(b) Medical assistance program benefits.
Biennially, the amounts in 5
the schedule to provide the state share of medical assistance program benefits 6
administered under s. 49.45, to provide medical assistance program benefits 7
administered under s. 49.45 that are not also provided under par. (o), to fund the pilot 8
project under s. 46.27 (9) and (10), to provide the facility payments under 1999
9Wisconsin Act 9
, section 9123
(9m), to fund services provided by resource centers 10
under s. 46.283 and for, to fund
services under the family care benefit under s. 46.284 11
(5), and to provide coverage for topical fluoride varnish under 2001 Wisconsin Act ....
12(this act), section 11
. Notwithstanding s. 20.002 (1), the department may transfer 13
from this appropriation to the appropriation under sub. (7) (kb) funds in the amount 14
of and for the purposes specified in s. 46.485. Notwithstanding ss. 20.001 (3) (b) and 15
20.002 (1), the department may credit or deposit into this appropriation and may 16
transfer between fiscal years funds that it transfers from the appropriation under 17
sub. (7) (kb) for the purposes specified in s. 46.485 (3r). Notwithstanding s. 20.002 18
(1), the department may transfer from this appropriation to the appropriation 19
account under sub. (7) (bd) funds in the amount and for the purposes specified in s. 20
AB366, s. 4
20.435 (5) (h) of the statutes is created to read:
(h) Community water fluoridation.
The amounts in the schedule for 23
community water fluoridation grants under s. 250.13.
AB366, s. 5
49.45 (2) (a) 25. of the statutes is created to read:
(a) 25. Disseminate to health care professionals providing services 3
under the early and periodic screening, diagnosis and treatment program under 42
, and to parents or guardians of children eligible for services under the 5
program, information on the availability of, and coverage for, topical fluoride varnish 6
under that program and on the efficacy of topical fluoride varnish treatments in 7
preventing early childhood caries.
Note: Requires DHFS to disseminate information to health care professionals
providing services under the EPSDT program regarding fluoride varnish.
AB366, s. 6
49.46 (2) (b) 1m. of the statutes is created to read:
(b) 1m. Dental hygienists' services, limited to services that are 10
payable under subd. 1. and that are within the scope of practice of a dental hygienist.
Note: Provides for reimbursement under the MA program, of dental hygienists'
services, limited to those dental services currently payable under the MA program and
that are within the scope of practice of a dental hygienist.
AB366, s. 7
250.13 of the statutes is created to read:
12250.13 Community water fluoridation grants.
From the appropriation 13
under s. 20.435 (5) (h), the department shall award grants each year to applying 14
communities for any of the following purposes:
Purchase of water fluoridation equipment.
Construction of additional building space to house water fluoridation 17
Payment of salaries of employees who operate water fluoridation 19
Note: Sections 1
, 4, and 7 of this bill provide $25,000 GPR in each year of the
2001-03 biennium for a community water fluoridation grant program. The grants may
be used for: (a) purchase of water fluoridation equipment; (b) construction of additional
building space to house water fluoridation equipment; and (c) payment of salaries of
employees who operate water fluoridation equipment.
AB366, s. 8
250.15 (1) of the statutes is renumbered 250.15 (1) (intro.) and 2
amended to read:
250.15 (1) Definitions.
(intro.) In this section, "community: (a) "Community
health center" means a health care entity that provides primary health care, health 5
and social services to low-income individuals.
AB366, s. 9
250.15 (1) (b) of the statutes is created to read:
(b) "Qualified applicant" means an entity that provides, or seeks to 8
provide, dental care services to low-income individuals and that does not receive a 9
federal grant under 42 USC 254b
(c), (g), or (h).
AB366, s. 10
250.15 (2) (d) of the statutes is created to read:
(d) From the appropriation under s. 20.435 (5) (fh), the department 12
shall distribute to qualified applicants grants totaling $1,600,000 in fiscal year 13
2001-02 and $1,600,000 in fiscal year 2002-03 to enable the applicants to provide 14
or expand provision of dental care services. The department shall give preference 15
for grants to qualified applicants that are located in dental health professional 16
shortage areas, as designated under 42 CFR part V, appendix B. Applicants who 17
receive grants under this paragraph shall do all of the following:
1. Make every attempt to collect appropriate reimbursement for its costs in 19
providing dental services to persons who are eligible for and receiving badger care 20
health care, medical assistance, or assistance for medical expenses under any other 21
public assistance program or have coverage under a private insurance program.
2. Prepare and utilize a fee schedule for the provision of its services consistent 23
with locally prevailing charges that is designed to cover its reasonable costs of 24
operation and prepare a corresponding schedule of discounts to be applied to the
payment of such fees. The discounts shall be adjusted on the basis of the patient's 2
ability to pay.
3. Establish a governing board that, except in the case of an applicant that is 4
an Indian tribe or band, is composed of individuals who are representative of persons 5
served by the applicant and a majority of whom are being served by the applicant. 6
The board shall be responsible for the following:
a. Establishing policies surrounding the entity's program operations.
b. Holding regularly scheduled meetings and keeping minutes of the meetings.
c. Approving the selection or dismissal of an entity's director or chief executive 10