LRBs0344/1
TJD:cjs&wlj:jm
2013 - 2014 LEGISLATURE
ASSEMBLY SUBSTITUTE AMENDMENT 1,
TO ASSEMBLY BILL 718
March 4, 2014 - Offered by Representative Sanfelippo.
AB718-ASA1,1,13 1An Act to amend 15.07 (1) (cm), 46.031 (2), 46.031 (2g) (a), 46.031 (2g) (b), 46.031
2(2r) (b), 46.031 (3) (a), 46.031 (3) (b), 46.031 (3) (c), 46.034 (3), 46.175, 46.18 (1),
346.18 (3), 46.18 (4), 46.18 (11), 46.18 (12), 46.18 (13), 46.18 (14), 46.18 (15), 46.19
4(4), 46.21 (2) (a), (j), (k), (m) and (q), (2m) (a) and (b) 1. (intro.), (3), (3g), (3r), (4),
5(4m) (a) and (b) and (6), 46.56 (1) (a), 46.56 (2) (a), 46.56 (2) (b), 46.56 (3) (b) 11.,
646.56 (4) (d), 46.56 (15) (b) (intro.), 51.08, 51.20 (18) (a), 51.42 (1) (b), 51.42 (3)
7(a), 51.42 (3) (ar) 8., 51.42 (3) (ar) 14., 51.42 (3) (b), 51.42 (4) (a) 2. (intro.), 51.42
8(6m) (intro.), 51.42 (6m) (c), 51.42 (6m) (i), 51.42 (6m) (m) 3., 51.423 (11), 51.44
9(4), 51.61 (1) (e), 51.61 (1) (f), 55.001 and 59.53 (7); and to create 13.94 (1) (mg),
1015.07 (1) (b) 24., 15.07 (3) (bm) 7., 15.195 (9), 17.07 (3r), 20.435 (5) (kf), 51.41
11and 59.53 (25) of the statutes; relating to: Milwaukee County mental health
12functions, programs, and services, creation of the Milwaukee County Mental
13Health Board, and making an appropriation.

The people of the state of Wisconsin, represented in senate and assembly, do
enact as follows:
AB718-ASA1,1 1Section 1. 13.94 (1) (mg) of the statutes is created to read:
AB718-ASA1,2,142 13.94 (1) (mg) No later than January 1, 2017, and biennially thereafter,
3perform a financial and performance evaluation audit of the Milwaukee County
4mental health board and of mental health functions, programs, and services in
5Milwaukee County including a review of the effectiveness of the Milwaukee County
6mental health board and new policies implemented under that board in providing
7mental health services, a review of the expenditures of the Milwaukee County
8mental health board, a review of Milwaukee County's expenditures for mental health
9functions, programs, and services and the outcomes of those programs and services
10in the period after the formation of the Milwaukee County mental health board. The
11legislative audit bureau shall file a copy of the audit report under this paragraph
12with the distributees specified in par. (b) and the Milwaukee County executive and
13the Milwaukee County board of supervisors. The audit under this paragraph does
14not count toward the limit of audits of a county in a calendar year in par. (m).
AB718-ASA1,2 15Section 2. 15.07 (1) (b) 24. of the statutes is created to read:
AB718-ASA1,2,1716 15.07 (1) (b) 24. The Milwaukee County mental health board, subject to s.
1715.195 (9).
AB718-ASA1,3 18Section 3. 15.07 (1) (cm) of the statutes is amended to read:
AB718-ASA1,3,819 15.07 (1) (cm) The term of one member of the government accountability board
20shall expire on each May 1. The terms of the 3 members of the land and water
21conservation board appointed under s. 15.135 (4) (b) 2. shall expire on January 1.
22The term of the member of the land and water conservation board appointed under
23s. 15.135 (4) (b) 2m. shall expire on May 1 of an even-numbered year. The terms of

1the appraiser members of the real estate appraisers board and the terms of the
2auctioneer and auction company representative members of the auctioneer board
3shall expire on May 1 in an even-numbered year. The terms of the members of the
4cemetery board shall expire on July 1 in an even-numbered year. The term of the
5student member of the Board of Regents of the University of Wisconsin System who
6is at least 24 years old shall expire on May 1 of every even-numbered year. The terms
7of 6 of the members of the Milwaukee County mental health board appointed under
8s. 15.195 (9) (b) shall expire on May 1 of an even-numbered year.
AB718-ASA1,4 9Section 4. 15.07 (3) (bm) 7. of the statutes is created to read:
AB718-ASA1,3,1210 15.07 (3) (bm) 7. The Milwaukee County mental health board shall meet 6
11times each year and may meet at other times on the call of the chairperson or a
12majority of the board's members.
AB718-ASA1,5 13Section 5. 15.195 (9) of the statutes is created to read:
AB718-ASA1,3,1614 15.195 (9) Milwaukee County mental health board. (a) There is created a
15Milwaukee County mental health board, which is attached to the department of
16health services under s. 15.03.
AB718-ASA1,3,1817 (b) Subject to par. (d), the board shall consist of the following 11 voting members
18appointed for 4-year terms except for the members under subds. 10. and 11.:
AB718-ASA1,4,219 1. A psychiatrist or psychologist who is suggested by the Milwaukee County
20board of supervisors. The Milwaukee County board of supervisors shall solicit
21suggestions for psychiatrists and psychologists from organizations including the
22Wisconsin Medical Society, the Medical Society of Milwaukee, the Wisconsin
23Psychological Association, the Wisconsin Psychiatric Association, and the Wisconsin
24Association of Family and Children's Agencies for individuals who specialize in a full
25continuum of behavioral health services for children. The Milwaukee County board

1of supervisors shall suggest to the governor 4 psychiatrists and psychologists for this
2board membership position.
AB718-ASA1,4,113 2. A psychiatrist or psychologist who is suggested by the Milwaukee County
4board of supervisors. The Milwaukee County board of supervisors shall solicit
5suggestions for psychiatrists and psychologists from organizations including the
6Wisconsin Medical Society, the Medical Society of Milwaukee, the Wisconsin
7Psychological Association, the Wisconsin Psychiatric Association, and the
8Milwaukee Co-occurring Competency Cadre for individuals who specialize in a full
9continuum of behavioral health services for adults. The Milwaukee County board
10of supervisors shall suggest to the governor 4 psychiatrists and psychologists for this
11board membership position.
AB718-ASA1,4,1912 3. A representative of the community who is a consumer of mental health
13services and who is suggested by the Milwaukee County board of supervisors. The
14Milwaukee County board of supervisors shall solicit suggestions for individuals who
15have experienced mental illness or substance abuse from organizations including
16Warmline, the Milwaukee Mental Health Task Force, and the Milwaukee
17Co-occurring Competency Cadre. The Milwaukee County board of supervisors shall
18suggest to the governor 4 representatives of the community for this board
19membership position.
AB718-ASA1,5,320 4. A psychiatric mental health advanced practice nurse prescriber who is
21suggested by the Milwaukee County board of supervisors. The Milwaukee County
22board of supervisors shall solicit suggestions from organizations including the
23Wisconsin Nurses Association for individuals who specialize in a full continuum of
24behavioral health and medical services including emergency detention, inpatient,
25residential, transitional, partial hospitalization, intensive outpatient, and

1wraparound community-based services. The Milwaukee County board of
2supervisors shall suggest to the governor 4 psychiatric mental health advanced
3practice nurse prescribers for this board membership position.
AB718-ASA1,5,124 5. An individual specializing in finance and administration who is suggested
5by the Milwaukee County executive. The Milwaukee County executive shall solicit
6suggestions from organizations including the Wisconsin Hospital Association, the
7Wisconsin County Human Services Association, and the Public Policy Forum for
8individuals with experience in analyzing healthcare operating expenses, revenues,
9and reimbursement, knowledge of public and private funding and systems, and
10expertise in financial restructuring for sustainability. The Milwaukee County
11executive shall suggest to the governor 4 individuals specializing in finance and
12administration for this board membership position.
AB718-ASA1,5,2013 6. A health care provider with experience in the delivery of substance abuse
14services who is suggested by the Milwaukee County executive. The Milwaukee
15County executive shall solicit suggestions from organizations including the
16Wisconsin Nurses Association and the Milwaukee Co-occurring Competency Cadre
17for health care providers specializing in providing substance abuse services. The
18Milwaukee County executive shall suggest to the governor 4 health care providers
19with experience in the delivery of substance abuse services for this board
20membership position.
AB718-ASA1,6,321 7. An individual with legal expertise who is suggested by the Milwaukee
22County executive. The Milwaukee County executive shall solicit suggestions from
23organizations including the Legal Aid Society of Milwaukee, Legal Action of
24Wisconsin, Community Justice Counsel, and Disability Rights Wisconsin for
25individuals who have legal expertise specializing in emergency detention regulatory

1requirements including policies, procedures, provider responsibilities, and patient
2rights. The Milwaukee County executive shall suggest to the governor 4 individuals
3with legal expertise for this board membership position.
AB718-ASA1,6,134 8. A health care provider representing community-based mental health
5service providers who is suggested by the Milwaukee County board of supervisors.
6The Milwaukee County board of supervisors shall solicit suggestions from
7organizations including the Wisconsin Nurses Association, the Milwaukee Health
8Care Partnership, the Milwaukee Mental Health Task Force, and the Milwaukee
9Co-occurring Competency Cadre for health care providers specializing in
10community-based, recovery-oriented, mental health systems. The Milwaukee
11County board of supervisors shall suggest to the governor 4 health care providers
12representing community-based mental health service providers for this board
13membership position.
AB718-ASA1,6,2314 9. An individual who is a consumer or family member representing
15community-based mental health service providers and who is suggested by the
16Milwaukee County executive. The Milwaukee County executive shall solicit
17suggestions from organizations including the Milwaukee Health Care Partnership,
18the Milwaukee Mental Health Task Force, and the Milwaukee Co-occurring
19Competency Cadre for consumers and family members representing
20community-based mental health service providers. The Milwaukee County
21executive shall suggest to the governor 4 consumers or family members representing
22community-based mental health service providers for this board membership
23position.
AB718-ASA1,7,424 10. The chairperson of the county community programs board in Milwaukee
25County under s. 51.42 (4), or his or her designee who is not an elected official as

1defined in s. 5.02 (3m). If the chairperson of the county community programs board
2in Milwaukee County is an elected official, the chairperson shall designate a member
3of the county community programs board who is not an elected official to be a member
4under this subdivision.
AB718-ASA1,7,65 11. The chairperson of the Milwaukee Mental Health Task Force, or his or her
6designee.
AB718-ASA1,7,87 (c) Subject to par. (d), the board shall consist of the following 2 nonvoting
8members appointed for 4-year terms:
AB718-ASA1,7,199 1. A health care provider who is an employee of a higher education institution
10suggested by the Medical College of Wisconsin. The governor shall solicit
11suggestions from the Medical College of Wisconsin for individuals specializing in
12community-based, recovery-oriented mental health systems, maximizing
13comprehensive community-based services, prioritizing access to community-based
14services and reducing reliance on institutional and inpatient care, protecting the
15personal liberty of individuals experiencing mental illness so that they may be
16treated in the least restrictive environment to the greatest extent possible, providing
17early intervention to minimize the length and depth of psychotic and other mental
18health episodes, diverting people from the corrections system, when appropriate, or
19maximizing the use of mobile crisis units and crisis intervention training.
AB718-ASA1,8,520 2. A health care provider who is an employee of a higher education institution
21suggested by the University of Wisconsin—Madison. The governor shall solicit
22suggestions from the University of Wisconsin—Madison for individuals specializing
23in community-based, recovery-oriented mental health systems, maximizing
24comprehensive community-based services, prioritizing access to community-based
25services and reducing reliance on institutional and inpatient care, protecting the

1personal liberty of individuals experiencing mental illness so that they may be
2treated in the least restrictive environment to the greatest extent possible, providing
3early intervention to minimize the length and depth of psychotic and other mental
4health episodes, diverting people from the corrections system, when appropriate, or
5maximizing the use of mobile crisis units and crisis intervention training.
AB718-ASA1,8,76 (d) 1. The governor shall nominate individuals for appointment under par. (b)
71. to 9. in consultation with the Milwaukee County executive.
AB718-ASA1,8,98 2. The governor shall ensure that one of the members under par. (b) 1. and 2.
9is a psychologist.
AB718-ASA1,8,1210 3. A person nominating or suggesting individuals for nomination under par. (b)
11shall attempt to ensure that individuals suggested are among the most-qualified
12and experienced in their field.
AB718-ASA1,8,1713 4. a. In this subdivision, "cultural competency" means the ability to understand
14and act respectfully toward, in a cultural context, the beliefs, interpersonal styles,
15attitudes, and behaviors of persons and families of various cultures, including
16persons and families who receive mental health services in Milwaukee County and
17persons and families who provide mental health services in Milwaukee County.
AB718-ASA1,8,2018 b. Members under par. (b) collectively shall possess cultural competency and
19shall reflect the population that is serviced by the Milwaukee County mental health
20system.
AB718-ASA1,8,2221 5. No member of the board may be an employee of Milwaukee County at the
22time of nomination.
AB718-ASA1,9,423 6. No member of the board may be a lobbyist, as defined in s. 13.62 (11). No
24member of the board may directly or indirectly solicit or receive subscriptions or
25contributions for any partisan political party or any political purpose while

1appointed to the board. No member of the board may engage in any form of political
2activity calculated to favor or improve the chances of any political party or any person
3seeking or attempting to hold partisan office. No member of the board may hold an
4elected office. Any violation of this subdivision is adequate grounds for dismissal.
AB718-ASA1,9,125 7. No member under par. (b) may serve more than 2 consecutive terms in a
6membership position for which suggestions for nomination are made by the same
7individual or entity, except that a member may serve 3 consecutive terms in a
8membership position for which suggestions for nomination are made by the same
9individual or entity if one of those 3 terms is for less than 2 years. An individual who
10has served 2 consecutive 4-year terms or 3 consecutive terms totalling less than 10
11years is eligible to be suggested for nomination as a member under par. (b) after the
12individual has not served on the board for 12 months.
AB718-ASA1,6 13Section 6. 17.07 (3r) of the statutes is created to read:
AB718-ASA1,9,1514 17.07 (3r) (a) Notwithstanding sub. (3), a member of the Milwaukee County
15mental health board may be removed by any of the following:
AB718-ASA1,9,1616 1. The governor, for cause.
AB718-ASA1,9,2117 2. If the Milwaukee County executive suggested the member for nomination,
18the Milwaukee County executive, for neglect of duty, misconduct, malfeasance in
19office, failure to attend 4 board meetings in one year, or failure to attend 2 board
20meetings within one year without providing advance notice to the chairperson of the
21board.
AB718-ASA1,9,2422 3. If the Milwaukee County board of supervisors suggested the member for
23nomination, the Milwaukee County board of supervisors, for neglect of duty,
24misconduct, malfeasance in office, failure to attend 4 board meetings in one year, or

1failure to attend 2 board meetings within one year without providing advance notice
2to the chairperson of the board.
AB718-ASA1,10,53 (b) Notwithstanding sub. (3), a member of the Milwaukee County mental
4health board shall be removed by the governor for engaging in an activity under s.
515.195 (9) (d) that disqualifies an individual from board membership.
AB718-ASA1,7 6Section 7. 20.435 (5) (kf) of the statutes is created to read:
AB718-ASA1,10,107 20.435 (5) (kf) Milwaukee County mental health board; audit. All moneys
8received under s. 51.41 (6) (b) for the general program operations of the Milwaukee
9County mental health board and for the performance of the audit and the completion
10of the report under 2013 Wisconsin Act .... (this act), section 53 (4 ).
AB718-ASA1,8 11Section 8. 46.031 (2) of the statutes is amended to read:
AB718-ASA1,10,1612 46.031 (2) Assessment of needs. Before developing and submitting a proposed
13budget to the county executive or county administrator or the county board or the
14Milwaukee County mental health board
, the county departments listed in sub. (1)
15shall assess needs and inventory resources and services, using an open public
16participation process.
AB718-ASA1,9 17Section 9. 46.031 (2g) (a) of the statutes is amended to read:
AB718-ASA1,11,1018 46.031 (2g) (a) The department shall annually submit to the county board of
19supervisors in a county with a single-county department, the Milwaukee County
20mental health board in Milwaukee County for matters related to mental health,
or
21the county boards of supervisors in counties with a multicounty department a
22proposed written contract containing the allocation of funds and such administrative
23requirements as necessary. The contract as approved may contain conditions of
24participation consistent with federal and state law. The contract may also include
25provisions necessary to ensure uniform cost accounting of services. Any changes to

1the proposed contract shall be mutually agreed upon. The county board of
2supervisors in a county with a single-county department, the Milwaukee County
3mental health board in Milwaukee County for matters related to mental health,
or
4the county boards of supervisors in counties with a multicounty department shall
5approve the contract before January 1 of the year in which it takes effect unless the
6department grants an extension. The county board of supervisors in a county with
7a single-county department, the Milwaukee County mental health board in
8Milwaukee County,
or the county boards of supervisors in counties with a
9multicounty department may designate an agent to approve addenda to any contract
10after the contract has been approved.
AB718-ASA1,10 11Section 10. 46.031 (2g) (b) of the statutes is amended to read:
AB718-ASA1,11,2012 46.031 (2g) (b) The department may not approve contracts for amounts in
13excess of available revenues. The county board of supervisors in a county with a
14single-county department, the Milwaukee County mental health board in
15Milwaukee County for matters related to mental health,
or the county boards of
16supervisors in counties with a multicounty department may appropriate funds not
17used to match state funds under ss. 46.495 (1) (d) and 51.423. Actual expenditure
18of county funds shall be reported in compliance with procedures developed by the
19department, and shall comply with standards guaranteeing quality of care
20comparable to similar facilities.
AB718-ASA1,11 21Section 11. 46.031 (2r) (b) of the statutes is amended to read:
AB718-ASA1,12,1122 46.031 (2r) (b) If the department withholds a portion of the allocable
23appropriation under par. (a), the county department affected by the action of the
24department may submit to the county board of supervisors in a county with a
25single-county department or to its designated agent, to the Milwaukee County

1mental health board if related to mental health in Milwaukee County,
or to the
2county boards of supervisors in counties with a multicounty department or their
3designated agents a plan to rectify the deficiency found by the department. The
4county board of supervisors or its designated agent in a county with a single-county
5department, the Milwaukee County mental health board if related to mental health,
6or the county boards of supervisors in counties with a multicounty department or
7their designated agents may approve or amend the plan and may submit for
8departmental approval the plan as adopted. If a multicounty department is
9administering a program, the plan may not be submitted unless each county board
10of supervisors which participated in the establishment of the multicounty
11department, or its designated agent, adopts it.
AB718-ASA1,12 12Section 12. 46.031 (3) (a) of the statutes is amended to read:
AB718-ASA1,13,813 46.031 (3) (a) Citizen advisory committee. Except as provided in par. (b), the
14county board of supervisors of each county, the Milwaukee County mental health
15board, as applicable,
or the county boards of supervisors of 2 or more counties jointly
16shall establish a citizen advisory committee to the county departments under ss.
1746.215, 46.22, 46.23, 51.42, and 51.437. The citizen advisory committee shall advise
18in the formulation of the budget under sub. (1). Membership on the committee shall
19be determined by the county board of supervisors in a county with a single-county
20committee, the Milwaukee County mental health board, as applicable, or by the
21county boards of supervisors in counties with a multicounty committee and shall
22include representatives of those persons receiving services, providers of service and
23citizens. A majority of the members of the committee shall be citizen and service
24consumers. The committee's membership may not consist of more than 25% county
25supervisors, nor of more than 20% service providers. The chairperson of the

1committee shall be appointed by the county board of supervisors establishing it or
2by the Milwaukee County mental health board, if it establishes the committee
. In
3the case of a multicounty committee, the chairperson shall be nominated by the
4committee and approved by the county boards of supervisors establishing it. The
5county board of supervisors in a county with a single-county committee or the county
6boards of supervisors in counties with a multicounty committee may designate an
7agent to determine the membership of the committee and to appoint the committee
8chairperson or approve the nominee.
AB718-ASA1,13 9Section 13. 46.031 (3) (b) of the statutes is amended to read:
AB718-ASA1,13,1710 46.031 (3) (b) Alternate process. The county board of supervisors, the
11Milwaukee County mental health board, as applicable,
or the boards of 2 or more
12counties acting jointly may submit a report to the department on the open public
13participation process used under sub. (2). The county board of supervisors or the
14Milwaukee County mental health board
may designate an agent, or the boards of 2
15or more counties acting jointly may designate an agent, to submit the report. If the
16department approves the report, establishment of a citizen advisory committee
17under par. (a) is not required.
AB718-ASA1,14 18Section 14. 46.031 (3) (c) of the statutes is amended to read:
AB718-ASA1,13,2419 46.031 (3) (c) Yearly report. The county board of supervisors or its designated
20agent, the Milwaukee County mental health board, as applicable, or the boards of 2
21or more counties acting jointly or their designated agent, shall submit to the
22department a list of members of the citizen advisory committee under par. (a) or a
23report on the open public participation process under par. (b) on or before July 1 of
24each year.
AB718-ASA1,15 25Section 15. 46.034 (3) of the statutes is amended to read:
AB718-ASA1,14,25
146.034 (3) With the agreement of the affected county board of supervisors in
2a county with a single-county department, the Milwaukee County mental health
3board, as applicable,
or boards of supervisors in counties with a multicounty
4department, effective for the contract period beginning January 1, 1980, the
5department may approve a county with a single-county department or counties
6participating in a multicounty department to administer a single consolidated aid
7consisting of the state and federal financial aid available to that county or those
8counties from appropriations under s. 20.435 (7) (b) and (o) for services provided and
9purchased by county departments under ss. 46.215, 46.22, 46.23, 51.42, and 51.437.
10Under such an agreement, in the interest of improved service coordination and
11effectiveness, the county board of supervisors in a county with a single-county
12department, the Milwaukee County mental health board, as applicable, or county
13boards of supervisors in counties with a multicounty department may reallocate
14among county departments under ss. 46.215, 46.22, 46.23, 51.42, and 51.437 funds
15that otherwise would be specified for use by a single county department. The budget
16under s. 46.031 (1) shall be the vehicle for expressing the proposed use of the single
17consolidated fund by the county board of supervisors in a county with a single-county
18department, the Milwaukee County mental health board, as applicable, or county
19boards of supervisors in counties with a multicounty department. Approval by the
20department of this use of the fund shall be in the contract under s. 46.031 (2g).
21Counties that were selected by the department to pilot test consolidated aids for
22contract periods beginning January 1, 1978, may continue or terminate
23consolidation with the agreement of the affected county board of supervisors in a
24county with a single-county department, the Milwaukee County mental health
25board,
or county boards of supervisors in counties with a multicounty department.
AB718-ASA1,16
1Section 16. 46.175 of the statutes is amended to read:
AB718-ASA1,15,11 246.175 County institutions: minimum standards. Notwithstanding any
3other provision of law, any county currently operating an institution established
4under s. 49.70, 49.71, 49.72, 51.08, or 51.09 may, by resolution of the county board
5or, in Milwaukee County for institutions providing mental health treatment, the
6Milwaukee County mental health board
, designate such institution or distinct part
7of such institution as a facility to be operated under s. 50.02, 50.03 or 50.33. Any
8county institution or part thereof, where so designated, shall be required to meet
9those licensure standards established by the department for the type of facility
10designated by the county. Any designation under this section may be made only if
11such designation will not result in any additional cost to the state.
AB718-ASA1,17 12Section 17. 46.18 (1) of the statutes is amended to read:
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